Laserfiche WebLink
!��`:''1� L��i�:�'-"� <br /> APPLIC�:t10N FOR CONSTR�CTION <br /> PERMIT <br /> t�e Ererynen <br /> GTY OF everetl <br /> everett e <br /> BUILDING DEPARTMENT . <br /> 25E•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> NER AUILA�DflE55 GIfY ZIP PNONE <br /> �TA�,� H. �r:��F;� 2�a3z is>NOnI 5F �ro,�Ra� �82�a �3�3�;- 0,�"�� <br /> IENMIT MAIL�DDNE55 CItY IP pNONE <br /> 11NCNREGfOR0E51GNEH MML���PE55 �ItY ZIP PMONE <br /> OENENAICANTIUCTOR 1MIL1100RE55 GIiY 2iP PNONE UCENSE• <br /> � /�I.c.P�/' <br /> MECHAN CONTRACTOP AUIL��OHE53 GTY IIP PMONE � LICENSE• <br /> PLUMBNOCANiR�1CiOR M�IL�DORESS CITY ZIP %IDNE LICENSE• <br /> QARS OF MOHK <br /> ❑ NEW ❑ ADDITION ❑ ALTEMTION ❑ REPAIp ❑ DEMOLITION ❑ WOOOSTOVE/FRPLINSEPT ❑ BUILDINGREIOCATION <br /> TEHIWT IMPRWEMEM CR INTENION REMO�EL ONLY COMACT VEPSON ANO PNONE H0. <br /> CONiIUCTPR�CEOFWDRK cTi1� iTctE;' 6Z3 -o33/ <br /> DE9CRIBE WONN�ND SOUME FOOT�GE INVOLVEO <br /> j° 04 MdL 15/fian/ O ,r <br /> `/PROP175E0 USE OF BUILDING I HEREBY CERTIFV iHAT I HAVE READ AND E%AMINED THIS APPLICATION AND <br /> .� <br /> ONC KNOW 7 HE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> IEMLpE9CR1VT10NOFPROPEFTY�SHOWN9ELOWOH�RAGMFOUflCOP1ES) ORDINANCESGOVERNINGTHISriPEOFWORKWILLBECOMPLETEDWITH <br /> � �oT�'� e�oGc2�L— oF - P ESUME TO G VE AUTHORIN O V�IOLA E OR CAfNCEI THEEPROVIS�ONS OF <br /> L/J Or pNYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> y � FORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE OWNER OF <br /> THIS PROPER7V TO PERFORM THE WORK FOR WHICH APPL�CATION IS MADE <br /> AND I COMPIY WITH THE STATE CONTPACTORS LAW iB27 pCW AND <br /> 298.200 WAG <br /> L p,t � �(5 SIGN�NPEOFCONTfUCTUROPAU1110Bi2'D�OENi D�tE <br /> � X ' � � � <br /> PIqJECiMORES$ �t <br /> )/ AP G�IISCITYBU9 iE LIGENSENO.AN� INESSN�ME <br /> Co�a� �. <br /> PWMBINO MECHANICAI <br /> NO. TYPE OF FI%TUpE OH ITkM FEE NO. TYPE OF EOUIPM�NT FEE <br /> WATER CLOSET�TOILEn A/C-NHNDLG UNITS-H.P. <br /> BATHNB FORCED AIR SYSTEMS-B.T.U. M EA <br /> LAVATORY�WASHBASIN� UNITHEATERS-flT.U. M <br /> SMOWER CI.OTHES DRYERS <br /> KITCHEN S�NK 6 DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> IAUNDRYTRAY WATERMEATER <br /> CLOTMES WASHER WOOD STOVE <br /> URINAI META�FIREPLACE 8 CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACEINSERT <br /> FLOOR ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> POOF ORAINS-RAl11LfADEFiS E%HAUST FAN <br /> SINK�SERVICE-BAR ETC� <br /> 4 <br /> SUBTOTAL S SUBTOTAL S <br /> � PERMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> FIqNT6ET&�CN REAPSEiBGGN SIDESETBACY. PIAMCNECNMUMBER FEE 11ECEIPfNO. <br /> us¢zonE �or�H€� VAG�Ni51LE FEES VALUATION FEE <br /> f �YEs o Ho <br /> ttPEOFCONST. OGGUPANCY6ROUP NOOFDWEt4N0UNli9 BUILDINO <br /> KLOW�BLFII�CTU�L <br /> i PLUMBING <br />� &ZEOFBIpQ NO.OFSTOflIE3 BSMT. OCCLO�� <br /> o v MECHANICAL <br /> ON <br /> NEIGNfLIMIUTION OTHER <br /> FlRE BPIIIHItLER3 REOUIREO o r[s o No STATE BUILDING SURCHARGE <br /> STATE ENERGV SURCHAfiGE <br /> MRICNTIDNACGBY IRANS�FP0.BY <br /> Puouc woaKs <br /> TOTAL <br />