Laserfiche WebLink
, <br /> i ��PPLICATION FO�' . ' <br /> } �TM°"'"° CONSTRUCTION c�e <br /> � everett PERMIT <br /> � BUILDING DEPARTM[KT <br /> � 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> � ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING O S�GN <br /> � OWNER M�ILAODHE59 CITY SIP PNONE <br /> � CISow,d scNonc cr i,�.��n uc.r�4,v NPzI d�EOC,ItF6N wNY t=l�r_'R6YT s��2- lG9s ' <br /> � ARCHRECTOROE910NER M�IL�D�PE9S CI7Y ZIP pHONE . � � <br /> � <br /> � OENERALCONTP�C70R M�LLADORE94 CITY ZIP PNONE UCENSE• <br /> �j S�PfAIdR �-�6aADY• Nw• S'J/7 /�%rrA�ENc /7k'D�faND 96a�i pQ)ro'uf C'�At.tF.I iy� Y.s� <br /> � MECN�NIC�LCONTMCTOq MAILAOORES! CIIY � IiP PNONE IICEN9E+ <br /> ' PWMlINOCONTR�CTOR MMLAODNE00 CIIY 21P PIIONE , UCENSE• <br /> CL�O!Of WORN <br /> ;� I� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPl.INSERT ❑ BUILDING RELOCATION <br /> � � WLU�TIONOF�pR�GOSTOFM�TERI�LSPWSL�B01� <br /> � ' 3lon.v o <br /> �ESGPIqE WORK <br /> ° _1 N 5l'A!.� S�p S/C,N c N u� <br /> � UBE OF BUILOINO � � <br /> I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> :i PLICATION AND KNOWTHE SAMETO BETRUEANDCORRECT.ALL <br /> � LEO�LOESCRIPT�ONOFPROPER�Y�BHOWNBELOWOPATT�CHFOUNCOPIE9� pqOVIS10NSOFLAWSANDORDINANCESGOVERNINaTHISTVPE <br /> ' OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHEqE• <br /> �� �or_e�ocK—or INORNOT.THEGRANTINOOFAPERMITDOESNOTPRESUMETO <br /> + GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF <br /> '� ANY OTHER STATE OR LOCAL LAW REOULATINO CONSTRUCTION <br /> �! . OR THE PERFORMANCE OF CONSTRUCTION. . � <br /> � lIONATURE OF CONTRACTOR OR AUTHOR¢ED AOENT O�TE��t <br /> :� X lJ,w % 9 13 G <br /> � YHOJEGT�00(1ESS APPUC�Ni5C1TYtlU51NE55LICEN5EN0. <br /> � 9� . , <br /> i <br /> PLUMBINO MECHANICAL <br /> NO. TYOE OF FI%TUNE FEE NO. 7YPE CF EOUIPMEN7 FEE <br /> :� WA7ER CLOSE7��OILE7) AIR GONO.UNITS-H.P.EA <br /> � BATHTUB REFRIGERAiION UNITS-H.P.EA <br /> UVATORV WA511 BASINI BOILER�H.P.EA <br /> SHOWER OAS FIRED AC.UNITS-TONNAGE EA <br /> � KITCHEN SINKB OISP. FORCED AIR SYS7EM5-B.T.U. M EA <br /> .y �ISHWASHEti WALL HEATERS-B.LU. M <br /> � LAUNDRYTFAV UNITHEATERS-B.T.U. M <br /> .�3 CIOTHES WASHER EVAPORATIVE COOLERS <br /> � WATER HEATER � � CLOTHES DRVERS _ <br /> URINAL VENTILATION FAN <br /> � DRINNINO FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIq HANDLIN6 UNIT- C.F.M. <br /> i VACUUM BREAKERS STOVE <br /> i) ROOF OMINS-RAINLEA�ERS METAL iIREPLACE 8 CHIMNEY " <br /> � SINK SERV�CE-DAR.ETC. WOOUSTOVE/FIREPLACE INSERT _ <br /> ] <br /> � . <br /> � <br /> � -_ 9UB TOTAL SUBTOTAL ! <br /> PERMI7 t PENMI7 f <br /> TOTALFEE � TOTALFEE f <br /> � ' � . <br /> THIS PORTION TO BE COMPLETED BY BUILDIPJG DEPT. PERSONNEL <br /> j FPONf5E18�CK REARSETB�CK 910ESEfBACK Pt6NCMECNNUMBER PUNGHECKFEE <br /> � FEE RECEIPf NO. <br /> � VSEIONE LOiANEA VACANT517E <br /> DVES ONO FEES VAlUAT10N f[E <br /> h iYPEOFCONST. OCGUP6NCYCFOUP NO.OFDWELUNOUNI�9 <br /> � <br /> �� BUILOINO f <br /> (1 SI2EOFBLOQ NO.OFSTORIES M�XOCGLOAD <br /> � PI.UMBINO . . . -. .-._.. . <br /> 5 � <br /> � <br /> � MECNANICAI <br /> �� FIRE SPRINKLERS REOUtRED ❑YES O NO . <br /> �� OTHER � ' ' <br /> 1 PENALTY - . . . . <br /> 7� APPLIC�f10NACG.BY PLANSCNECI(EOBY APP0.FOfl149U�N/�p��� <br /> i+� '�-"^�-• TOTAL <br /> t� <br /> S <br /> ,� <br /> �i <br /> � . .�,�`-��� <br /> �� <br /> r. <br /> .. ..... . . . . . . �. . . . ,..r . <br />