Laserfiche WebLink
`�,;PPLICATION FO�� <br />rn�e..ro�Nn CONSTRUCTION <br />��ro. <br />everett PERMIT <br />BUILDING DEPARTAIENT <br />259•BB10 TO BE COMPLET�D IN INK- PLEASE PRINT <br />❑ DEMOLITION C7 COMBINATION � BUILDING Y�MECHANICAL <br />O PLUMBIN� <br />O SIGN <br />�PCNIIECIURDkYONfN J ^�^••^��^••� // . <br />V <br />(iENER�I GONINAGIOf1 M�R AOU�E55 Citt ZiP �upNE L�LEiiSE • <br />..... .___�..� nrv ii� {'HONE LICENSE • <br />M�R <br />bP <br />4lwii Vr �vnn �y <br />❑ NEW ❑ A�DITION Le� ALTEFATION ❑ HEPAIR I� DEMOLITION ❑ WOODSTOVE/FRPL.INSEFT ❑ UUILDING RELOCA7ION <br />WLU���ONOf WOANIGO510� ���ARRi451'WSL�B0111 <br />�o�—e�oc�— <br />PLUMBING <br />USE lONE <br />TYPE OF FI%TURE <br />WATER CLOSET �TOILET� <br />BATMTUB <br />U�ATORY (WASM BASIN� <br />SHOWER <br />Y.ITCMEN SINK 6 OISP <br />OISHWASHER <br />UUNORYTRAY <br />CIOTMES W�SMER <br />URINAI <br />DRINKING fOUNTAIN <br />FLOOR ORRIN <br />BACKFLOW PREVENTERS <br />t700F DRAINS — NAINLEADE <br />SINN �SEHVICE — B/ A. ETC � <br />SUBTOTAL <br />CEHMIT <br />TOTALFEE <br />Of S10PiE5 <br />GOPIE51 <br />VAC�HT Slf[ <br />❑rE5 ONO <br />NO OF OwFI <br />•YP�I[AlIOH1CC 9v f'UNSCN[CMEOBY I�PPH fON <br />I HER[BY CERTIFY THAT I HAVE READ AN� EXAMINED THIS AP• <br />PLICATIONhNOKNOWTHESAMETOBETRUEANDCORRECT.ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING 1HIS TVPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED hiERE� <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW f7EGULATING CONSTRUCTION <br />OR THE PEFiFORMANCE OF CONST9UCTION. . <br />SIGN�TORE Of CUNTRRCTOR OR �UTHJf1iZED AGENi D�IE <br />l� , n %� . . ., / . <br />HO <br />MECHANICAL <br />TYPE OF E�UIPMENT <br />NC —�/HNOLO UNITS — H V. <br />REFRIGERATION UNITS — HP. EA. <br />8011ERS — B.i.U.iM P. <br />GAS FIRED A.C. UNITS — B.T.U. <br />'FORCED AtR SYSTEMS — B.T.U.�� M <br />WRLLHEATERS—B.T.U. M <br />UNITMEATERS—B.T.U. M <br />EVAPOAATIVE COOLERS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RnNOEHOOO <br />WA1ER HEATER <br />WOOOSTOVE <br />MET�L FIREPUCE 6 CH�MNEY <br />FIREPIACE INSEF7T <br />HEATPUMP <br />QA$ PIVINO <br />FXNAl15T FRN <br />SUBTOTAL <br />VCpMIT <br />PIAN CMECKNUMBER �fEE <br />FEE <br />RECEIPT NO. <br />FEES VALUF71un rcc <br />BUILOING 5 <br />PI,UMBING <br />MECHANICAL <br />OTMEfl <br />STATE BUILDING SUHCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORNS <br />TOTAL <br />PROPERN OWNERS AFE RESPONSIBLE FOR �ETERMINING ALL <br />PROPERTV LINE LOCATIONS AND RELATEO EASEMENiS. <br />