Laserfiche WebLink
,�,E„,p�,� �;�PPLICATION FO� <br /> CONSTRUCTION °°"`" <br /> cm oF <br /> everett PERMIT e <br /> BUILDING DEPARTMENT <br /> 259-8745 TO !3E COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWIIER M�IL�OpPESS CITY 21P PNONE <br /> wec sv7- v3ss' <br /> �T m �000cl< 5.3a2 y 4� /l�� /��_ Ev�' 98�03 ��M 3ss' - �/.� 7 <br /> ARCNITECTORDESIONER M�IL�pONE55�� (ILY ZIP PIIONE <br /> GENERAI GONfR�C10R M�IL�ODNE55 CITY 21P PI�ONE LICENSE• <br /> S/�/f. <br /> MECH�NIULCONIR�L10q M�IL�D011E55 CITY � 21P PHONE UCENSE• <br /> PLUMB��IOGONiR�CfGd MML��ONE55 GiY 21P PpONE LILENSE• <br /> C1�550F WORN <br /> ❑ NEW � ADDITION ❑ AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�lU�iiON OF WORN�COSi Of M�I[t11AL5 PWS UBOR� <br /> '�'700 <br /> UESCA18E WORN <br /> Gv �t.�l�7 � <br /> USE OF BUIl01N0 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> PLICATIONAND KNOW THE SAMETO BETRUE AND CORRECT.ALL <br /> lE6�LDE5CRIPTIONOFPROPERfY�SHOWNBEIOWORATi�LHFOURCOPIES) PROVISIONSOFIAWSANDORDINANCESGCVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> �or_e�oc�or IN OR NOT.THE GRANTING OFA PERMIT OOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OFi CAN�;[L THE PROVISIONS OF'� <br /> ANYOTHER STATE OR LOCAL LAW REUULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SICNATURE OF CONTRqCTOR OR AUiHOPIZED AGENT DATE <br /> X � �/� <br /> PPOJEGiADORESS APP NiSCITYB ESSLIGENSE�10. <br /> .7.3� �D���' <br /> PLUMBINO MECHANICAI <br /> NO. TYPE OF FIXTUHE FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSETITOILEn AIR COND.UNITS-H.P.EA. <br /> BATMTUB qEFRIGERAiION UNITS-H.P.EA <br /> LAVRTORY�WASH BASIN� BOILER^rH.P.EA <br /> SHOWEF GAS FIRE�AC.UNITS-TONNAGE EA <br /> KITCHEN SINK 8 DISP. FORCEO AIR SVSTEMS-B.T.U. M EA. <br /> DISHWASHER WALL HEATERS-B.T.U. M <br /> LAUNDRV iRAV UNIT HEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORA7IVE COOLERS <br /> WATER HEATER CLOTMES DRVERS <br /> UR�NAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FIOOR DRAIN AIR HANDLING UNI7- C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DPAINS-RAINLEADERS METAL FIREPLACE 8 CHIMNEV <br /> S�NK ISEFVICE-BAR,ETC. WOODSTOVE/FIFEPLACE INSEFT <br /> SUBTOTAL SUBTOTAL 3 <br /> PERMIT 3 PERMIT ! <br /> __ TOTALFEE i TOTALFEE t <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> iNONI5E18�CK f1E�NSEIBRCK SIDESETBACK PL�NCHECKNUMOEP PLANCNECKFEE i <br /> FEE RECEIPT NO <br /> USE20NE LOTRIIE� VACANTSIiE <br /> OYES ONO FEES V�LU�TI�N FEE <br /> ttPEOiGONST. OCCUPRNCYGROI:P NOAFUWELLINGUNITS <br /> BUILDINO 5 <br /> SRE OF BLW. NO OF SiORIES M�X OCC.LOAO <br /> PLUMBING <br /> MECNANICAL <br /> FIRE SPRINKLERS FEOUIRED ❑ VES ❑ NO <br /> OiHER <br /> PENALTY <br /> >PPUL4110N�CC BY PLnNSGNECNEOBY APPR.FORISSU�NGEBY � — <br /> TOTAL <br />