Laserfiche WebLink
._ ..., _ .. ......,.... ._..., ._... .._,...... r_ � <br /> ��+PPLICATiON FO�;� ���,�„ <br /> '"""`°"'" CONSTRUCTION e <br /> Qn OF <br /> everett PERMIT <br /> TO BE CONPLETED IIJ BLACK INK— PI.EASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBlNG ❑ SIGN <br /> OWN M�IL�D�RE55 CITV ZIP PNOHE <br /> �</�.N�2,0 L�Ns��c�� p0 /�aa' �'.6� io�,�'c,� 9�'z7L ��l�S"S� � _ <br /> ♦RCHRECTORDE910NEH MML�ODRES9 UT' tIV GNJNE <br /> OENEh�LCONTR�CT�R MML�DDRESS CILV ZiP PHJNE LICENSL• <br /> MECHANIL�LCONT{1ACTOq M�IL�O�RE59 CITV ZiP �HONE ULENSE• <br /> ,�d' � L Cc.r.�sT r,�7r�:�., �U .6'ox n9� ' ,G'oT!/�LL 9�j/ �/�S6LZ Z ��L-Gaa- iv= <br /> PLUMlINOCONTP�CTOR MAIL�D�RE89 LITY 21P PHONE �6Y��5� <br /> CL�53OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSIOVE/FRPL.INSERT CI OUILDING RELOCATION <br /> VAIU�TION OF WORk 1�09T OF M�TERI�LS PLUS L�B01i1 <br /> DE9CRIBE WORN <br /> u.vr - u � � <br /> U.aE OF BUIIDINa � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• � <br /> PLICATIONANDKNOWTHESAML=TOBETRUEANDCORRECT.ALL m <br /> LEpALOESGf11PTIONOFPROfENTY19110WNBELOWOH�TT�CMiOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNIN�THISTYPE <br /> OF WORK VJILL BE COMPLETED WITH WHETHEF SPECIFIED HERc• �.. ...� <br /> ior_e�oc�ur IN OR NOT.THE GRANTING OF A PERMIT DOCS NOT PRESUME TO --1 � <br /> GIVE AUTHOFITY TO VIOLATE OR CANCEL '�HE PROVISIONS O� .. ._.� <br /> . ANYOTHERSTATEORLOCALLPWREGULATINGCONSTRUCTION �+ m <br /> — OR THE PERFORMANCE OF CONSTRUCTION. p <br /> ICaNRTURE OF CONTRACTOR OR AUTNOFIZED AGENT DATE C � <br /> mo <br /> � <br /> X O 3 <br /> m <br /> -� z <br /> PROJEGT�DORE85 PP CANi9GItYBU51NE55liCEH5EN0. m -1 <br /> �2� � oZ <br /> � <br /> PLUMBINO MECNANICAL � _ <br /> Np, TYPE OF FI%NRE 'EE NO. T'PE OF EOUIPMENT FEE �.. .. <br /> WATER CLOSET TOILEQ AIF COIJD. UNI75—H,P.EA. _ � N <br /> < <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. __ _ � 0 A <br /> LAVATORV WASH BASIN BOIIERS—H.P.EA. � 3 <br /> � SNOWER GAS FIRED AC.UNITS—TONNAGE EA , Y f'1 <br /> KITCHEN SINKB�ISP. FORCED AIR SYSTEMS—B.T.U. M EA. � f�� �-. <br /> N <br /> DISHWASNER WALLNEATERS—B.f.U. M p <br /> LAUNDRVTRAY UNITHEATERS—B.T.U. M CN <br /> CLOTHES WASNEF EVAPOhATIVE COO'.ERS � 3 N <br /> WATER HEATER CLOTHfS ORYERS � Z � ' <br /> URINAL VENTILATION FAN _ � m <br /> DPINKING FOI�NTAIN RANGE HOOD � � <br /> FLOOR DRAIN �IP HANDL�NG UNIT— :.F.M. <br /> VACUUM BREAKERS STOVE _ _ <br /> ROOF DRAINS—RAINIEADER9 METAL iIREPLACE 8 CHIMNEV _ _ <br /> SINK SERVICE—BAR,ETC. +VOO�STOVE/FIRFPLACEINSENT � <br /> � E/ UM PJ� � _ <br /> . � <br /> N <br /> Z <br /> — O <br /> — suoiorn� s Qb i � � <br /> SUDTqTAL .- C� • <br /> PERMYT f PENMIT s _ �� ' m <br /> TOTRL FEE f� TOTAI FEE S .Q <br /> 1"HIS P�P�TION TO BE COMPLETED BY �UILDING DEPT. PERSONNEL <br /> fONiSEIBRCK AE�fl:iETOACK SICESEi9FLN PLANCl/ELKNUMBER PUNGHECNfEE �� ' <br /> �EE AECEIPi N�, � <br /> 1'f,EZONE �OT�REA y�C/.Ni51TE <br /> FEE9 VALUATIQN fEE , <br /> OYES �NO <br /> VPCOFGONST. OCCUPANCVGROUP NOAFUWEL!INOIINIiS <br /> BUILOING f <br /> H2E OF BLDO. NOAF SLORIES MA%OCQ LORO <br /> PLUMBIN6 <br /> MECHANICAL ! <br /> �"IRE SPFINKLERS REOUIRI_D ❑ YES ❑ NO <br /> OTHE.'. <br /> PENALTY � <br /> �PPIIC�TIOH�CG.BV PlANSCMELH[D BY APP0.FOF ISSU6NCE BY �- � <br /> L ,oT�� ��o ,0�7 � <br /> L_ G - C.. - <br /> i <br /> . ; <br />