Laserfiche WebLink
���� <br />r,..,. � ... <br />fMErMpmn I',• P L I CAT 1 O N F O k�=� <br />��n« CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPAFTMENT <br />259-8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL <br />owp¢p _ M111L �DDRESS _ CIIY ZIP <br />Ti%. � ,r <br />���.� <br />e <br />❑ PLUMBING �N <br />PHONE <br />' U.3sG <br />7 UCENSE• <br />. ZZDO <br />IICENSE • <br />r. � � si�,vA� � i.�3G�� <br />fR�CTOR M�IL �DDNE55 CIiY 21G PIIONE ICENSE • <br />: 5. �, �. si�� A.r � �s£� � � <br />,� ADDITION ❑ ALTERATION ❑ REPAIp ❑ DEMOLITION ❑ WOODSTOVE.FRPL.INSERT � BUILDINO RELOCATION <br />YqIK �C09T OF MATERUL9 PIUS I�BORI <br />:S�Z oa <br />� <br />, <br />�or_ <br />/LUMlIN6 <br />..�, � <br />�f cii:n <br />OF <br />TOT11L <br />S ��/D <br />ITEM <br />-� Ia • _ <br />. -,.•�_ . <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATIONAND KNOW THE SAME TO BETRUEANDCOFRECt. ALL <br />PROVISIONSOF LAWSAND GRDINANCESGOVERNINCaTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THF GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STA7 E OR LOCAL LAW REGULATING CONSI'RUCTION <br />OP. THE PERFORMANCE OF NSTRUCTION. . <br />SION�TUREOFCONTRACT ROR T R12EUAOENT OAIE <br />X /;f"� /� —, l7/r�C. /1./J1� � i <br />MECHANICAL <br />FE� NO. TYPE OF EOUIPMENT <br />NC — AMNOLQ UNITS — H.P. <br />REFRIGEMTICN UNIT$ — H.P. EA. <br />BUILERS — B.T,U.M.P. <br />OAS FIRED A.C. UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNITHEATERS—B.T.U. M <br />HEAT <br />� To,� fu j � <br />vUN CHECK NUMBER � FEE � RECEIPT NO. <br />v�curT srte FEES <br />OVE9 ONO <br />NO.(IFOWELLINAUNIT9 BUILDING <br />PLUM9ING <br />M�X OGC. LOAD <br />MECHANICA� <br />O7HER <br />STATE BUILDINO SURCHAR6 <br />STATEENEROYSURCNARGE <br />ervn. von �asuer+r,c�fr�, _ p�BUC WJNK3 <br />.U.1G. <br />tz•�e •8 7 <br />- <br />3 <br />AFE RESPONSIBLE FOR OETERMININ6 ALL <br />ATIONS AND RELATED EABEMENT& <br />