Laserfiche WebLink
� � 4�_.PPLICATION FO..,, evereM <br /> '"""'°"'" CONSTRUCTION 0 <br /> �,r o. <br /> everett PERA�IT <br /> BUILDIIJG DEPARTMENT <br /> 259-8745 TO BE COMPLET[:D IN INK• PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBINO k��31(iN <br /> OWNFR M�IL�0�11F59 CIIY ZIP PNONE <br /> �AR�O�'VvvDS l�G z92v ��aesrn/ur E��2E�" �3Z '�3S`! <br /> MCIIIIECIU�OES�04EN M�R�0011fl9 CIfY IIP ONf <br /> OEN[MIGONIR�C�011 M�Ill10UfIE55 CIfY IIP PIION[ LICEHSE• <br /> �ZYE� S/Cn/ Cf.. /�.CS f. /�iNf 51:� Sli17J�L� `�g/1-2 jzN-.3oYC Fo-tC-YS�G2'��D <br /> MFCNI1NIUl COHIIIAf�IOq M�IL AOOI�CS$ C�IY SIP 1`IIONE LIfiEN$E• <br /> VLUMpM�C9NIP�f,1011 M�IL�OD0059 L��Y TIP PRONE UCEMSE• <br /> CL�39O/W011R <br /> ❑ NEW ❑ �DOIfION ❑ ALTERATION ❑ (lE{'AIR ❑ DEMOLI110N ❑ WOODSTOVE/FRPL.INSERi ❑ BUILOINO RELOCRTION <br /> wiu•nnN�nwanr�co��nrM•�r��•�er�mi.�nom ;ssTJ,is � <br /> I a.psil / NvcvAc� (s� AG mi,vv.n rArf D Si(..vSC_�j3+cib L" C�� S±c z$'�F•" SiGN (A�� ���L <br /> OFlG�IBF.WOOM �y �v�u �q�.w)fJ O.J E, f'alv.a•vn/. J�c.V Cr�� LJ�u_ JF Re�/ .�L.�v7fD <br /> U�v i}v(.K i�''N /i'A.r - �A�i.vC. t✓ilT b�PfrT✓�J <br /> ueco euunina -I / �/_ I HEREBV CERTIFV THAT I HAVE HEAD AND EXAMINED TNIS AP• <br /> � ' � •;lll���t- _ PUCATIONANDKNOWTHE3AMETOBETRUEANDCORRECT.ALL <br /> ico � s mPnoHo�rnor[nrnenowen[iawon�ttec���ounconicm pqOVI310N90FlAW5ANDOR0INANCES00VERNIN4THI5TVPE <br /> OF WORK WILL BE COMPLEIED WITN WHETHER SPECIFIED HERE• <br /> io�_.nioc�—or IN OR NOT.TI1E GRANTINp OF A PERMIT OOES NOT PRESUME TO <br /> OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHEfi SiATE OR LOCAL LAW REOULAiINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�lUREOiCONIMGfOROR�UT110P12ED�0ENT O�fE <br /> X <br /> PPOICGI�OU�Efl3 ��PLIG�NY9CItYOU41NES4LICGN9E NO <br /> � ( � I N'' ' z/C%U <br /> PLUMBIN4 MECHANICAL <br /> NO. t1'PE OF FI%TURE FEE NO. n'PE OF EOUIPMENT FEE <br /> W�TEf7 CLOSET(TOILEn RIH COND. UNITS-R P.E�. <br /> BATHTUB REFRIQERATION UNIT9-H.P.EA , <br /> l�V�IORY IW�9N BI15�N� BOILERS-H P.E�. <br /> SHOWER OAS FIREU�A.UNITS-iONNAOE EA <br /> NITCHEN SiNN6 DISP. FOf10E0 AIR 9YSTEM3-B.TD. M EA. _ <br /> D�SNW�SHER W�LL HEATERS-B.T.U, M � <br /> L�UN�RY7RAV UNITNEATENS-B1.U. M _ <br /> CLOTHES W�SNER EV�POR�TIVFCOOlER9 _ <br /> WAiER HEIITER CLOIHES DRYENS ____ <br /> UPiNRL VENTILAiION F�N <br /> O�INKINO FOUNTAIN RANOE 1100U <br /> iLOOR ORAIN �IR NANDLINO UNIT- QF M. _ <br /> VACUUM B�7E�REf19 SLOYE _ <br /> �OOF DRAINS-RAINLEAbERS MEtAI IIREPUCE 6 CIIIMNEY <br /> SiNR�S[RVICE-BRR,EIC WOOD9fOVE/FIREPLACE IN9ERT _ <br /> 8UB TOTIIL 8UB TOTAL • <br /> PERMIT ! PERMIT � <br /> 70TI1L FEE � TOT�L FEE t <br /> THIS PORTION TO BE COMPLETED EiY BUILDING DEPT. PERSONNEL <br /> fnONISFIO�CK �C��S[1p�CK 9�U[9EIB�CI. PL�NLeFCnN11MBE11 �UNC�IECKfEE <br /> «E PECEIPINO <br /> USElONE lUl��l• y/,��NISiiE V�W�lION f![ <br /> fFEt <br /> ❑YES ONO <br /> IYYE Of GO'19� UCCU1'�NCY G110OP NO OI OWELlINO UNIIS <br /> BU�LOINQ f � < <� <br /> SitE Or p�po NO CI SIOIIIES M�I(OCC 1 pAll <br /> FLUMBINO <br /> MEC�I�NICAL <br /> FIRE SPNNNLENS RCOUIRC� Ll VES ❑ NO <br /> OTIIER <br /> PEN�IIY <br /> APPIICAl10'IAf.f. PY 1'1��156�IFLFEOBY �PPOf011155U�N flV — " <br /> �t� � T0TI1L __ <br /> I <br /> _ 3 ,Sg7 <br />