Laserfiche WebLink
� <br /> r �he Evero�esn �� A P P L I C A'�1 O N �� �J R everett <br /> ��TM°F CONSTRl1CTION � <br /> everett PERMiT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUiLDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECIiANICAL C� PLUMBING �SIGN <br /> OWNER MAILAO�RE55 CIIY ZIP PIIONE <br /> S%//�cEl.' �,- ,��rl(_ y6c:Z Cvu.��cl2 �aVt#y ��'�k'�� Wa-��b'Zos 2S8 3�`�2 <br /> ARGHilECi0RUE51GNER Id�ILR0�NE55 Gltt ZIP PNONE <br /> GENEBRLCONTflAGTOR MAILqDDRE55 CIiY ZIP PI�ONE 4GENSE• <br /> MECNRNICNLCONtMCIOB IARIL/DD1iE55 CITY 21P PIION[ LICENSE• <br /> PWMBRlpCONTRACTOP /L MAILApOPE55 Cltt ZIP PHONE IICENSE� <br /> S:lZLTN lric ,�1,'.r �'t�.,�—�--�� ���7� , �� <br /> LL�SS OF WOflN <br /> L7 NEW ❑ ADDITION Q� ALTERATION ❑ PEPAIR ❑ DtMOLITION ❑ W0CIDSTOVE/FRPL.INSERT ❑ BUILOING flELOCA710N <br /> z <br /> VAL WTION OF WORN(COST OP MAtER14L5 PWS Lh80R� O <br /> � � S �G�tL9 G'�-�Cr� _ � <br /> ��HTie,EwQa� � .f- p , , m <br /> u.l.L� ��..�nL�'7�.v,,�vl r7'�- CN't E:C/S��^-�" ....� � <br /> usE or auaov+c � � �-+ <br /> � • I HEREBY CERTIFY THAT I HAVE READ ANJ EXAMINED THIS� • � T� <br /> � .l� � N ' � " l O PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL .. � <br /> LEGFLDESCiiIP10NOFPROPERiY�SMOWNBELOWORATtACf1FOURCOPIES� PROVISIONSOFLAWSAN�ORDINANCESGOVERNINGTHISTYPE �� _ <br /> OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE- o m <br /> �or_o�ocr�_ov INORNOT.THEGRANTINGOFAPEFMITDOESNOTPR'SUMETO mo <br /> GIVE AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS O� � <br /> ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION o3 <br /> OR THE PERFORMANCE OF CONSTRUCTION, m <br /> SIGNAiURE OF CONTR�CTO(i OR AUiIIORIZED AGENT DATE _ � <br /> �Q m <br /> xC ,C� ,l — �O � CI � c = <br /> PpOJECTRD�RE35 APPLICRNTS -ITYBU�FlESSLICENSENO. n � <br /> rx <br /> SU2 `� C�c�'�%�c'e�„ t,J,u =, ^ <br /> K <br /> PLUMBING MECHANICAL T <br /> o v <br /> NO. TVPE OF FIXTURE FEE NC. TYPE OF EOUIPMENT FEE T n <br /> 3 <br /> WA1ER CLOSET(TOILE7) AIR COND.UN�TS-H.P.EA. _ �'� <br /> BATHTUB �7EFRIGERATION UNIiS-H.P.EA f*1�-+ . <br /> N <br /> LAVATORY�WASH BASINI BOILERS-H.P.FA. O <br /> 51 W WLII UA3 f111CU A.C. UNI I S�-I V NNAI:C CA. O r <br /> . — t� m <br /> KITCHGN SINK 8 OISP. FORCED AIF SYSTEMS-B.T.U. M EA C N <br /> 3 tn <br /> 01511WASHEfl WALLHEATERS-B.T.U. M m <br /> Tn <br /> LAUNDRVTFAY UNITHEATERS-B.T.U. M � I- <br /> CLOTHES WASHER EVAPORATIVE COOLEfiS m <br /> D <br /> WATEF HEATER CLOTHES�FYERS � <br /> URINAL VENTILATION FAN � <br /> S <br /> DRINKING FOUNTA�N RANGE HOOD 3' <br /> Z <br /> FLOOF DFpIN _ AIR HANDIING UNIT- C.F.M. _ � <br /> VACUUM BPEANERS STOVE - <br /> ROOFDRAINS-MWLEADERS METAL FlREPLACEB CHIMNEY N <br /> � SINK SERVICE-BAR,EiC. WOODSTOVUFIREPLACEINSEFT Z <br /> O <br /> � <br /> ('i <br /> m <br /> SUBTOTAL SUBTOTAL S <br /> PEflM1T 5 PEHMIT 3 <br /> TOTALFEE S TOTALFEE S <br /> THIS PORTION TO BE COMPLETED BY BUIL.DING DEPT. PERSONNEL <br /> FRONIS°IDPGN REARSETBRCK SIOESEtOACN PLANCIIECKNUMpER P�RNCHEGKF[E <br /> FEE PECEIPiNO. <br /> USC ZONE tOT A(iEF ypCANi SItE <br /> OYES ONO FEES VPLUATION FEE <br /> TYPEOiCONST. OCCUPANCYGPOUP ND.OFOWELIINQUNliS <br /> BUILUING S <br /> SIZE OF BLDO. NOAF STORIES MA%.OCC.LOAD — <br /> PLUMOING <br /> � MECHANICAL <br /> FIRE SPfiINKLERS REOUIRED ❑YES ❑ NO <br /> OTIiEli <br /> PENALTY <br /> APPLIC�iIONpCC.OY PLANSCHLCNE�DY APPR.FOqI550ANCE8Y <br /> TOTAL <br />