Laserfiche WebLink
�o,,,,,� ':�.PPLICATION FO�.,' ���,�„ <br /> everett CONSTR Ui TION O <br /> PE M T <br /> BUILDING OEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> O DEMOLITION O COMBINATIQN ❑ BUILUING ❑ MECHANICAL ❑ PLUMBING ��SIGN <br /> OWH[R M�II�DONE59 GITY :JP P ONE <br /> �-',Yi-c•i�,/ G=% S'�1 l-?c7, 1_{�.,n ,j.40 :Sc-.di�tc�- �.C�7- S.£ �� <br /> S <br /> �RCMrt[CIONOESIONCF MML�ODRC59 GTY ZIP OHONE <br /> �I�-v.:.ZJ'.f-fo3 �'�3• <br /> OEHERe�CONIH�CION M�R�OORf.SS CITY LIP PHONE LICENSE• <br /> /�%��`i Y.� ,5�,�;,i .,� fllJt/. i(�'y /,��'aYy1r ;' �s:�i�t•'i.v�ii��/.��.f7i �f�4- /Jfj- <br /> .' . <br /> MECM�NIUI COHTt1�Ci0A MSIL�ODR[39 C�1Y 21P PNONE UCENSE• <br /> VLUMB�H9LOI11qI�G�OR M11L�D�RESS CIfY 21P PIIONB �ICENSE� <br /> CLA55Of WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMO'IiION l.7 WOODSTOVE/FRPL.INSEFT ❑ BUiIDING NELOCATION <br /> V�LU�TION Of WpnM�LOCL(MellN4L5 PW S L�B0111 <br /> ,, �.n��2i <br /> DESCHIBE M�01111 <br /> / <br /> �� /nl3�t� ti�< <t� :Y�c:� -/-'�z� <br /> usc or am�oum <br /> I HEREBY CERTIFY TfiAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATIONAND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEO�LOESG111P}IOMOFPPOPERTVISNOWNBELOWOBI1UCNfOURCOFI[.'i PROVISIONSOFLAWgpNDORDINANCESGOVERNINGTHISTVPE <br /> OF WORK WILL BECOMPLETED WITH WHETHERSPECIfIED HERE• <br /> io*_e�ocK_or IN OR NOT.THE GRANTIIVG OF A PERMIT DOES NOT PRESUME TG' <br /> GIVE AUTNORITY TO VIOIATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUC7iON <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIONATURE OF CON RCTO�R QN AUTI/OR12ED�CEIiT D�TE � <br />� X �--- ..r... _ V�`•^��-�- t�:- e. ,EZ r�"6 <br /> i <br /> �'ROJECTADDRE55 �APLICANiSOiYBU ME59UCENSENO. <br /> s;oa-- l3�lc�vti�•vy� t-�t�er_:T' n:,� . • � <br /> OLUMlINO MECHANIC�L <br /> NO. TYPE OF FIKTURE FEE � NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) AIR COND.UNITS—HP.EA. <br /> Br1iHTU8 FEFRIGERATION UNITS—N.P. EA. <br /> L/�/IORV�WASH BASIN� BOILEFS—HP.EA. <br /> SHOWER GAS FIREO A.C.UNITS—TONNAGE EA <br /> KITCHEN SINK 6 DISP. FOf7CED Alfi SVSTEMS—B.T.U. M EA. <br /> �ISHWASHER WALLHcATERS—B.T.U. M <br /> UUNORYTRRV UNITHEATERS—BT.U. M <br /> CLOTNES WASHER EVAPOfiATIVE COOLEPS <br /> WATER HEAIER CLOTHES DFYERS <br /> URINAL VENTIIATIOM FAN <br /> ORINKING FOUNTAIN qp.NGE HOOD <br /> FLDOR DRAIN AIR NANDLING UNIT— G.F.M. <br /> VACUUM BREANERS STOVE <br /> FOOf DPAINS—Ra1NLEADERS METAL F'IREPUCE 6 CNIMNEV <br /> S�NK�SERVICE—BAP.EiC. WOODSTOVE/FIREPLACEINSER* <br /> 9U9 T0TI1L SU9 TOTAI � <br /> PEqMIT f PERMIT f <br /> _ TOTALFEE � TOTALFEE t <br /> THIS PORTION TO BE C01�1PLETE�1 BY BUILDING DEPT. PERSVNNEL <br /> '�ONISEtA�CN R[MSLIBeGN 91pESElB6GK PL�NCHELkNUMO[R PLGNC�iECN![[ <br /> �EE REGEIPI NO. <br /> i5E ZObE L01 eqE� V�CRNT 51'E <br /> ❑YES ONO fEEB V111U11T10N FEE <br /> �YPEOiCONSt OCCUPANCYGFOIIP NO.OFOVlIiLL�N6UNli3 <br /> BUILDINO S <br /> ti�2E Of BLDO NO Of qTORIE3 MRK OCC.1 OAD - <br /> PIUMBINO <br /> MEC116NICFL <br /> �IAE SPRINKLEFS REOUIRED O VES O NO - <br /> OiIIER <br /> PENRLTY <br /> '�PPlICI110NACC OY f'lAl15f,11EGNEDOY RPCR.10f1'SSUAN �Y• -- <br /> �,�. TOTIIL <br /> - / � � , �� p}� Stt.Lil1 'nj '�jE" Lit..t� C70� <br /> PfZIU�� F2opl�.�, <br /> UZ '3l••� <br />