Laserfiche WebLink
��,�,,,,, h�'PLICATION FOR ����„ <br /> everett CONPERMITTION e <br /> � <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDIN� DEPT. <br /> 269•8745 ❑ COMBINATION ❑ BUILDIN(i �MECHANICAL ❑ PLUMBIN(i ❑ SION <br /> qyNnEp MAIL�DONE9S GITY ZIP PHONE <br /> 1 ((s.U.e•TALo <br /> ARCHIiEGT01t0ESI0NEN MAILADD E89 Cltt ZIP PNONE <br /> akAF� cc.,.sr ��a AX Y� l�.ce��l ,zo , <br /> OENEMICONTNACTOR MA�L�O�RE88 GTY 21P -GMONE LICENSE• <br /> MECN�IGL,CONTMG10Rn `��C�ILrA00RE99 O•U� ax 23 �pITM LYNW2IP (P 0�_Lu`' ,LI EN E• <br /> [:y uK u,��s�s,e . <br /> iLUM91NOCONTMCTOR MMLADOPE39 GITY ZIP PNONE LICENSE• <br /> CL�!!OF WORIf <br /> �.NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ UEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br /> VI1L WTION OF WORK�CA9T OF MATERqL9 PW S IABOIiI <br /> OESCPIBE WORI( <br /> U9E OF BUILUINO <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNO W THE SAM E TO 8E TRUE AND CORRECT,pLL <br /> LE011LDE9CRIPTIONOFPrMPERtY15NOWNBELOWORATTACHFOUNCOPIES7 pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br /> �or_e�oc�—or IN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> ANY OTHER STATE OR LOCAL LAW fiEGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF O TRUCTION. <br /> SI E OF TRAC R TH ZED AGENT OATE <br /> i� <br /> i <br /> VROJECTADDNE39 �VPLICANi3GITYBU51NES5Ll NSENO. <br /> � bt w <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) AIRCOND.UNI1S—H.P.EA <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> LAVATORY WA3H BASIN BOILERS—H.P.EA <br /> � SHOWER OAS FIRED AC.UNITS—TONNFGE EA <br /> KITCHEN SINK6 UISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> �ISHWASHER WALLHEATERS—B.7.U. M <br /> UUNDRYTRA'! . UNITHEATERS—B.T.U. M <br /> CLOTHES W�SHLR EVAPORAtIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILA7ION FAN <br /> DRINKINO FOUNTAIN RANOE HO00 <br /> FIOOR DAAIN AIR HANOLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE <br /> flOOF ORAINS—RAINLEADERS METAL FIREPLACE 6 CHIMNEY <br /> 81NK SERVICE—BRR.ETC. WOODSTOVE/FIREPLACE INSERT <br /> A.. <br /> HUBIOTAL 9UB TOTAL f <br /> PENMIT ! PERMIT f O <br /> TOTAL FEE • TOtAL FEE • dd <br /> THIS PORTION TO BE COMPLFTED BY BUILDING DEPT. PERSONNEL <br /> FRONT SE7BACN AE/�H SETBACK SIOE SETB�CI( PLAN CHECN NUMBEN PLAN CHECN FEE <br /> FEE pECEIPTNO. <br /> U9E ZONE LO7 AHEA y�CANT SITE <br /> FEEB VALU�TION FEE <br /> O\ES ONO <br /> TYPEOiGONST. OCGUPANCYGHOOP NO.OFOWELLINOUNITS <br /> BUILDIN6 f <br /> SRE OF BLDO. NO.OF STOHIES M�X OCC.LO�D <br /> PIUMBING <br /> MECHANICAL OV <br /> FIHE SPRINKLERS FEOUIRED ❑YES ❑ NO <br /> OTHEfl <br /> PF.NALTY <br /> 11PP�ICAiION ACC.BY Pl�N9 CHECREO BY APPP.fOR ISSU�NCE BY <br /> TOT�L <br />