Laserfiche WebLink
, .PPLICATION FO�: ���,�„ <br /> IMEwpn�n CONSTRUCTION � � e �� <br /> cirr oF <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 258-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING 0 SICiN , <br /> OWNER MAII�U�FE55 GI'Y 21P PHONE <br /> ,^;�, �r PFACl7CK �/So9 ��zesT �R �vE�e�Tr 9�Q3 .2S9-�c�83 <br /> �NCMITECTOROESIGNEP M�IL�OORESa Citt 21P PHONE <br /> S-LF � <br /> � <br /> GENEML CONTR�GTOP M�IL��OqE55 Gitt 21P oHONE IICENSE� <br /> MECM�NIC�LGONTF�CTOq M�IL�OORESS GITY IIP PHf.NC LICENSE• , <br /> S � <br /> PLUMBING CONTP�GTOR M�IL a0�RE55 Cltt 21P PI10NE LICEVSE� <br /> SF L� �: <br /> �. <br /> CUSS OF WORK �/ ' <br /> ❑ NEW �ADDITION L7 ALTERATION ❑ flEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION i� <br /> r <br /> WLU�jIONOF WORN�COSTOF M��S PLUSy�BORI i <br /> � � %Jr/ � <br /> DESLRiBE W NN <br /> � P ' <br /> use F BUILDING I HEREBY CEFTIFY THAT I HAVE REAO AND EXAMINED THIS AP• <br /> PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT.ALL <br /> LEG�LDESGRIPTI NOFPROPEF7YISMOWNBELOWOR�T7ACHFOIIRCOPIESI pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE i. <br /> �� T� �D��QL 7O � OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- <br /> lOT_�BLOCIC—�OF y IN OR NOT.THE GRANTING OF A PERMITOOES NOT PRESUME TO <br /> „ ,� GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> Oii THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGNATUREOFCONTR�CTORO THORIZEOAGENT D�TE <br /> g N X���tiuC� <4.2Kcer.�C� � /�% ' <br /> PROJECTAD�R 98 APPLIGANiSLITYBlI51NE54lILEN5EN0 I� <br /> Yo oREsr � � r�l� 7�3 C�w�ve� <br /> PLUMSING ' MECHANICAL <br /> NO. TYP!Pf FlXTURE OR ITEM FEE NO. T1IPE OF 80UIVMfNT �E <br /> W�TER CLOSET�TOILET) A/C—NHNOLO UNITS—H.P. <br /> �TMNB REFRIGERATION UNITS—H.P.FA. <br /> LAVATORY(WASH BASINI BOILERS--B.T.U./H.P. � <br /> i <br /> SHOWER OAS FIRED A.C.UNITS—B.T.U. i <br /> KITCHEN SINK 6 DISP. FORCED AIR SVSTEMS—B.T.U. M EA. � <br /> I <br /> DISHWII3MER WALLMEATEHB—B.T.U. M <br /> UUNDRVTRAV UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS � <br /> URINAL CLO7HESORVERS <br /> DRINKIN6 FOUNTAiN VENTILATION FAN <br /> ROOR ORAIN RANGE HOOD i� <br /> I, <br /> BACKROW PREVENTERS WATER HEATER <br /> ROOF DRAINS—RAINLEADERS WOOD STOVH i'� <br /> SINK ISERVICE—BAR.EiC,) MEfAI FIREPLACE 6 CHIMNEV �� <br /> i FIREPUCE INSEflT iI <br /> HEATPUMP <br /> �AS PIPtNd <br /> � EXHA1JSTfAN <br /> fUlTOTAL f !UlTOTAL <br /> PERMIT f KRWf <br /> TOTALFE! f TOTALfEE <br /> %.AN CHECK NUMBER FEE RECEIPT NO. �� <br /> VRONT SETB�CN NE�R SETBACK SIDE SETB�GK p�. /]� � �� � �� <br /> Zo ' Zo � G � OcY 2D3v`� Y <br /> USE20N� LOTARE� yAGAryTS�TE FEES VALUATON �E '' <br /> ( OYES��O <br /> BUILDING S � <br /> TVPEOFL NST OCCUP�NLVGROUP NOOFOWELLINGUNITS <br /> ,�N R�3 I PLUMBING - <br /> SIZE Oi BLO`3 NO OF STORIES M�%O�c `� MECHANICAL <br /> l00 SF �d n,p / N <br /> OTHER <br /> � FIRE SPRINKLERS REOUIRED ❑YES NO STATE BUILDING SUHCHARGE D • <br /> i. <br /> r. <br /> STATEENERGYSURCHARGE } <br /> nPPLIC�TION�CCBY PLANSCMECKEOBY �PPRFOPISSU�NLEBY pUBLICWORNS <br /> � TOTAL f <br /> w�.`�"' � � � <br /> PROPERN OWNERS ARE FESPONSIBLE FOR DETERMININO ALL I� <br /> PROPE9N LINE LOCATIONS AND RELATED EASEMENTS. <br /> 1 <br />