Laserfiche WebLink
A!';PLICATION FOR eVefe„ <br />I,ONSTRUCTION e <br />everett PERMIT <br />DGPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT,lVA98201 ❑COMBINATION ❑BUILDING ❑MECHANICAL ❑PLUMBING PERMITNO. <br />ownr �� T•4G 6 .�+nu nooens arr zir rirorvi <br />M/ N/ T— L c.[_L� ,5' /�/o �(J ��oo So. Jr.4cr„��.,rr.� �S�'o/% y�6 - 93 9/ <br />nxaur¢rosoesieN�a nunnnoaess arr zir virou <br />G[\IRAI [ONLRACION MAII AD�R6Y ❑tY ZIP f'IION[ llC(KSf M <br />E.�d� rs,• .r/. u/. i.v� _ /��'es—.r�� //h � �.rv_.�dD ��43 G?3 -3iue .!/Eg�,c.lrr zio,P✓ <br />nIFC11nMGlCON�FAQOR nfAILnO�NkSi CIiV LIC PIIOyE IICFNSEp <br />PIUAIpING CONTPACiOR <br />ClA$5 OF �5'OHk <br />❑NEW ❑ADDITION <br />VALOAfIOu pF N'ONK <br />�� <br />S �ODU <br />OfSCRINt N'ORA <br />ruo�os[o us[ a nunm�uc <br />UiY TIP PHOS'F <br />I <br />❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE y�SIGN ❑GARAGE I�OUILDING RELOCATION <br />ueni nacairrion� ov reoresrv is�+o�vr� nuow ox nrrnui voux corics� <br />ior oio�n _ oi <br />�OII AODRESS <br />�io� 01�' - �v.�.�c.c <br />PLUMBING <br />NO. TYPE OF FI%TURE <br />\l'ATCR CLOSET (TOLIET) <br />UATHTU❑ <br />LAVATORY �WASH DASIN) <br />SIIOWER <br />KITCI�IEN SINK & �ISP. <br />DISWASHfH <br />LAUNDRY TRAY <br />CLOTHF.S WASHER <br />WATER HPAY'.E <br />URINAI <br />OftIN1:INC fOUNTAIN <br />VACUUM IIREAKERS <br />ROOF D2.11N5-RAINLkAUERS <br />SINK (SCRVIC[-OAR, [TC ) <br />SIDE \'nHD <br />USE ZONk <br />OF CONA. <br />SUB TOTAI <br />PFRMIT <br />TOTAL(CE <br />STBEET $ITItACK <br />LOT AN[n <br />OCNPANCY GNOUP <br />NO OP STORICS <br />11A5[Mf N 7 I71 UW <br />APPR(1VAL5 <br />1. ENVINONMLNTAL CIIFCK LIST <br />2. f1UILl]INC PLAN$ <br />'-' 1. fIRF HYDRA�+T <br />.1 FlBE PHOiI UION SYSTEM <br />�i GHADIN(;'I�XCA'JA'i 10^1 R CUARINI2GHUBHING <br />4 ORI.INAf,I: <br />7. LNVIftONA1PrTAL IAIPACT STATEA7LDIT <br />B HEALTH DISiRICT <br />FEE <br />�f <br />RL\R YARU $[T11AC <br />VnCANT SIIE <br />❑Yf5 ❑KO <br />�O Of DN4LLING l <br />��1nX. OCC. 1 OAD <br />FIRf $P121NKLLRS <br />RI QUIRkD <br />f11'IS (�NO <br />OY DATf <br />I H[RE6Y CERTIFY THAT I hIAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TFiF SAME TO 6[ TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL fi[ COMPLIED bVITH WHETHER SPEClFIED HEREIN <br />OR NOT. TI1E GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVC AUTHORITY TO VIOLATE OF CANC[L THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAVJ RCGULATING CONSTRUCTION <br />OR TH[ PERFORh1ANCE Of CONSTRUCTION. <br />SIGi�AiURF OF CONTRnCTOR OR AUTHORI7.f0 nGCNT DATE <br />MECHANICAL (� <br />NO. TYPE OF EQUIPMENT FEE <br />AIR COND VNITS-HP [n <br />RI FHIGfR ��.1 if�� I IyITS -Y. P. in <br />IA <br />�- UNITS-TONYACf EA <br />1 �. )1'STC��15-B.T.U. b <br />v. �.,111In1ER5-OTL. M <br />UNIi HEATfHS-OT.U. M <br />evnrounriv� cooteus <br />VI:NTILAiION fAN <br />RANC[HOOD <br />AIR HANDLING UNIT- C.EM. <br />$TOVE <br />A1ET.11 HRLPLACf 8 CHIMNEY <br />SUBTOTAL f <br />PERMIT S <br />TO1Al FEE s <br />CIIECK NUAtUER PLAN CHfCK fF.E <br />FLE RKEIPT NO. <br />IEES VALUATION FEE <br />IiIIII.DING s /i�, d0 `� Q <br />L�.� <br />PWA1111NG <br />MFf.HANIUL <br />OTHfR <br />PI�NALTY UI7C - <br />SEC. 30Jf �l <br />70TAL I � <br />pCqM1T VALID4TION <br />\\'NfN PNOPLHI.Y \'ALIf)ATED (IN THI$ 51'ACC) THIS 151'OUR PERMIT <br />l—l..i� '',_. �'.:.._.�_..�i"i.�.St:.�%1�, p'�..".If �f`i ! i . <br />APPLICA710N ACC IIY I'_I CHECI.'fU FlI' APPR I OH KSU:\� Iil' <br />";�u �,- 2 i.s-`t�yo �� <br />n-�-�.� ��=����� �z"►' .��LG�-��:.,t%.tA�.� <br />