Laserfiche WebLink
In� Er�rprnn <br />cin or <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />`,.PPLICATION FO►�1 <br />CONSTRlJCTIUN <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />/ <br />❑ OEMOLITION ❑ COMBINATION U BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNE11 M�Il�00PE59 W�Y 21P PIIONE <br />SAN�,C'A rryr�. �.S�3Z Ck'i�Nv /l��� �.Ni�cf� �,Y.�vi � sZ-os-�/ <br />nnr.�u��uunms�mrtn M�aeoontss aiv Ziv vuovt <br />GFiiEfUi CONIPeC�Of1 MUL ��UO[55 Grv (iP nuOHE L�CENSE • <br />/'1/cfNP r- <br />Mr.r�u�nr.•i.eorrtn.emn M�iunoness ertv zin nnoNe ue[Nsc. <br />VWM9�N.CONIfPG10� M�I1..IVIJHE55 <br />CL�59O� WO�Y ,�/ <br />❑ NEW ❑ �DDIiION ❑ AITERATION L4" PEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDING RELOCnTION <br />v L'i+nur� or won. irr�� n� i.un m�is rius unom ' <br />�r�/. O r70 � <br />,,. � c"' .2� � • <br />use or ounmr� , <br />�l �Ff//)E/�1�� N <br />l[flet OtscP�rnov or ono�' <br />io�_ oiocK—o! <br />nno�cci �oon[ss /_ �/ P/ �' f f �C <br />7 <br />c�� ��' 1.�c��� e�-! y i�/���> ��S'.��� <br />PLUMBING <br />tYVE OF FIXTURE OR ITEM <br />WRTEN CLOSET ITOIIET� <br />9ATH1U0 <br />UVATORY IWASN BASIN� <br />SMOWER <br />NITCHEN $INK 8 DISP <br />LAUNORY TRI1Y <br />CIOTNES WASHER <br />UNINAI <br />OACNFLOWPREVENTERS <br />�OOF ORAINS —l1AINLE�OERS <br />SINN �SERVICE —BAR. ETC � <br />SUB TOTAL <br />PEIIMIi <br />101A1:EE <br />���u�rtsr�nue m�ese o�cn <br />��is[turn � ioinn[• <br />rn i.rnisi <br />s¢r or ui na <br />u�vi n::.nrn1 �cr. p. <br />vec��n snE <br />ores nNo <br />I HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED TH�S AP• <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVEHNING THIS TVPE <br />OF WORK WILL BE COMPLETED WIiN WfiETHEF SPECIFIED NERE• <br />IN OR NOT. THE GRANTING OF A PERMIT OOES NOT PRESUIdE TO <br />GIVE AUTI�IORITY TO VIOIATE OR CANCEL THE PROVISIOMS OF <br />ANYOTHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION <br />OR THE PERFORtdANCE OF CONSTRUCT�ON. . <br />SION�lUf1E OF CONIR�C70R Ofl AUINOf112E0 AGENt p�TE <br />X�L( G/�, �CaQ-t/ /J�ia�J'7 <br />♦PPl1UNiFGfY0t1.^.INESSIICEHSE NO <br />MECHANICAL <br />NO, TYPE OF EOUIPMEHi <br />A/C — A/HNOl6 UNITS — H P. <br />IiEiqIGERATICN UN�TS — N P. E'1. <br />OOtLERS — O.T.U./N P. <br />CAS FII7E0 A.C. UNITS — B.T ll. <br />fORCED A�R SYSTEMS — B T.U. M EA. <br />WALLNEATEFS—BS.U. M <br />UNITHEATEPS—B.T.U. M <br />EVAPONATIVE COOLERS <br />CLOTHES OFYEPS <br />VENTILAiION FAN <br />RANOEMO00 <br />WAiER NEAiER <br />WOOOSTOVE <br />METAL FIREPLACE 8 CNIMNEY <br />FIREPLACE �NSERT <br />HEAT PUMP <br />GAS PIPINC <br />ExHAUSTFAN <br />9UBTOTAL <br />V[RMIT <br />TOTAIFEE <br />PI.nNCHECNNUMBER IFEE �AECEIPTNO. <br />ew�oir+c <br />octu=nr�Gr cnour r�o or owruwa uNirs _ _ <br />i'I���iL��ECKE�OV �AfPP �OPISSU�NLEBV <br />i'LUMd�NG <br />MECHANICAL <br />OTHER <br />STATE OUIIDING SUi7CMA7G <br />STATFENERGYSURCHARGE <br />PUBLIC WOfiK9 <br />TOTAL <br />S <br />PROPERTYOWNERS APE RGSPONSIOLE FOR OETERMININ� AlL <br />PROPERTV LINE LOCATIONS AND HEIATED EASEMENTS. <br />