Laserfiche WebLink
..�,.. ....._.__._. . .. __ .____....._._. ..._--- -.._..�.._...__..._......�......._._._..,......_.._.__...... . .---- <br /> ,�.E,,,,�,� `;�.PP'LI CAT I O N FO�. ��,�,�„ <br /> G^of CONSTRUCTION e <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINi <br /> BUIIDING DEPT. <br /> 259•8745 ❑ COMBINATION �, BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEF MMLADDRESS Ci1V 2�n ANOHE <br /> Q�H . UVNAL�(r� �VE2G777" �fSZ.v l <br /> •RCMITECTOROESiONER M�RADDPE39 CiTV 2iP PNONE . <br /> S�M �PW�44D5 ,joo I�trv�,-rBNK SL3�G 6V�TZG17' 9PZo� ��`f SS�7 <br /> OENEfl�LCONTR�CTOR M�IL�DORE59 Gltt 21P PMONE LiCENSE• <br /> MECN�NIC�LCONTR�CTGq MAIL��UHE59 CITY ilv PHpNE LICENSE• <br /> PIUMBINQCONTPACTOR M�ILwpDNE69 CI1Y 21P PHONE �ICENSE• <br /> CUSS OF WORK <br /> ❑ NEW ❑ ADDIt10N ❑ AL7ERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEPT ❑ BUILDING REIOCATION <br /> MIUATI OF WORN�COBTOF M�TENULS PLU9 L�BOFI <br /> �IO,O�o 0 <br /> �ESGHIBE WORN <br /> 1 <br /> I1�L5`t�/kLL P.4R1"6Tlt�b�bS {al'�fZ�ofz L� iz O��bGES m <br /> USE OF BUILDINO „ <br /> ���G� I HEREBY CERTIFY THAT I HAVE 4EAD AND EXAMINED THIS AP• <br /> PLICATIJNANDKNOWTHESAMETOBETRUEANDCORRECT.ALL .+ .-. <br /> LEO�LDESCRIPTIONOFPROPERTY�SNOWNBELOWOR�TIACHFOUBCOPIES PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE '� � <br /> OFWORKWILLBECqMPLETEDWITHWHETIiEHSPECIFIEOHERE- .. 1 <br /> LOT_BLOC�OF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO �' _ <br /> GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISIONS OK o m I <br /> � ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OF THE PcRFORMANGE OF CONSTRUCTION. /p m n I <br /> SIGNATUREOFCONTRACTONOHAUTHORIZEDAGENT DATE (7/r '��S 03 ! <br /> m i <br /> ��i� G� Y � X � � m -� <br /> PR0.IELTAU�RE93� � AP �IG�NTSG IISI EggLIGENSE . q Z I <br /> a ' <br /> ,� -,- � _ <br /> PIUMBIN� ' MECMANICAL � in <br /> NO. TYPE OF FUITURE FEE NO. TYPE OF EOUIPMENT FEE � � <br /> WATER CLOSEi TOILE qlR COND.UNITS-H.P.EA. � p <br /> � <br /> BATHTUB REFRIGERA110N UNITS-H.P.EA. � � <br /> LAVAiORV WASH BASIN BOIlERS-H,P.EA. _ <br /> SHOWER GRS FIRED AC.UNITS-TONNAGE EA m N <br /> P�.ITCHEN SINKB DISP. FORCEO AIR SVSTEMS-B.T.U. M EA. O r <br /> DISHWASHER WALL HEHiERS-9.T.U. M � m <br /> — C VI <br /> __ LAUNDRV iHAV UNIT NEAiERS-O.T.U. M m V� <br /> CLOTHES WASHER EVAPORATIVE COOLERS Z n <br /> - -� r <br /> VJATER��EATER CLOTHES DRYERS • � <br /> URINAL VENTIIATION FAN A <br /> DFINKINO FOUNTAIN RANGE HOOD � <br /> FLOOR ORAIN A�q HANOUNG UNIT- C.F,M. S <br /> — a <br /> VACUUM BREAKER3 STOVE Z <br /> P�OOF DPAINE-RAINLEADERS METAL FIRE7LACE 8 CNINIJE�' � _ <br /> SINK g[qylCE-�BAR ETC. WOODSTOVUFIREPLACEINSERT N <br /> Z <br /> O <br /> --I <br /> — � <br /> m <br /> SUBTOTAL SUBTOTAL f <br /> PERMIT f PEIIMIT ! <br /> TOTALFEF_ f 10TALFEE t <br /> THIS PORTION TO BE COMPLEl'ED BY BUILDING DEPT. PERSONN�L <br /> iRONTSEIE�CN RENRSETBACN SIDESEi84CN PLANCNEGNNUMBEN PLANCNECKfEE <br /> N. �. �y� � FEE Ll � NEC�IPi NO �� <br /> USEZONE IOT�RE� �� `� <br /> C` � � � . V�CRNTSITF FEEB VALU�TION FEE <br /> OYES UIC' <br /> IVPEOFCOHST. 1,w OCGUPANCVGROUP NO.OFOWELtIN�UNli9 � <br /> �� ""_ �r � `- BUILDIHO S� � � <br /> 41ZE OF BLnUO. NO.Of STONIES M�%OCG LO D <br /> Z/L.I SF Z PLUMBIN4 � <br /> MECNRNICR. - <br /> FIRE SPRINKLERS REOUIPEO ❑VES L41W <br /> OTHER <br /> PENACPY <br /> APP4CAilON ACQ 9Y PUN9 CHECRED BV �PFR FOA iLSUANGE 8Y <br /> �. � J✓/ T�,A� � � � <br /> L -� <br /> �ro`� f�-t��c� M��� z-o <br /> �'t-� of3TAc u� 'f�'� A,�e�P�. <br /> �7T�t1cz�2. <br />