Laserfiche WebLink
'�::=:PPLIC�4TI�N FO.. , <br /> '°'E"'°'"° CONSTRUCTION °°°'°" <br /> cin or <br /> everett PERMIT <br /> BUILdING DEPARTMENT <br /> 259-8�45 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ StGN <br /> OWNER )� M�IL�OORE55 CILY iiP PIIONE <br /> �. L;� �///�Iz=/l�/(�,O.c/ /CO?/ -/��/�L- /�J �—Y��i�7T (J�1?r_� '� � •�_� .r�jr�c� <br /> 11RCNIfECTORDE510NEP � M�ILAOORESS CIIY 21P PIIONE <br /> J�� <br /> OENEH�LGONTRACTON M�ILAOOR[55 GIiY 2iP PI�ONE IIGENSC• <br /> MECN�NIL�LCONTR�CTOq M�IlA00RF55 CIIY ZiP PIIONE LIL[NSE• <br /> PtUMBINOCONfR�CIOq M�IL�OORE55 � CITY ZIP PIIONE �ICENSE• <br /> �CU OF WONN <br /> NEW ❑ ADDITION ❑ ALiERATION ❑ REPAI� ❑ DEMOLIi�ON ❑ WOODSTOVEIfRPL.INSERT ❑ BUILDING RELOCAiION <br /> VQU�TION OF WORK�COST O�M�TERI�LS FLOS L�BON�I � � �� � � <br /> f//='t_cJ T��-S (��-'SiLvs.� �a��:�G't.�.= �Oj ��m. Db <br /> DESCRIBE WORIt <br /> U9E OF BII�LOING <br /> � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> ���'�-� r �-� �S PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> IEO�lOESGRIPTIONOFVROPEg�r o ne¢i on�LT•cl/r�uR PIES� pROVISIONSOFLAWSANDOfiDiNANCESGOVERNINGTHISTYPE <br /> � �r�� �/I� 'S '"/ � �� ,.� �— OFWORKWILLBECOMPLETEDWITHWHETHEFiSPECIFIEDHERE <br /> e�oc ov �"'� ' IN OR NOT.THE GRANTING OF A PERMIT DGES NOT PRESUME TO <br /> GIVE AI!THORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> — ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNRTURE OF CONTPh Tpp pq AUTNORI2ED AGENT DAiE <br /> X �` . �J - 'l .o <br /> w <br /> VPQIEGTAOOpE55 �PPLIG�NTSCIiYBUS IESSLICEN ! <br /> ��� ���V '^i�+ 1 . <br /> PLUMBINO MECHANICAL � <br /> NO. TYPE OF Fi%TURE FEE NO. TYPE OF EOUIPMENT F'�_ <br /> WATERCIOSET�TOILEn BVO AIRCOND. UNITS-H.P.EA. � � <br /> BATHTUB � REFRIGERATI04 UNITS-H,P.EA <br /> LAVATORY WASH BASINI CD BOILERS-H.P.EA. <br /> SHOWER � I�A QAS F�RED AC.UNITS-TONNAGE EA <br /> NI7CHEN SINK 8 DISP. FORCED AIR SVSTEMS-B.T.U. M EA ' <br /> � DISHWASHER WALL HEATERS-B.T.U. M <br /> LAUNDRYTRAV UNITHEATERS-B.T.U. M <br /> CLOTHES WASHER EVAPORATIVECOOLERS <br /> ATER HEATER CLO7HE5 DRVERS <br /> URINAI VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DFAIN AIF HANDLING UNIT- C.F.M. <br /> VACUUM BREAKERS, STOVE <br /> ROOF DHA�NS-RAINLEADERS METAL FIREPLACfi 8 CHIMNEY Q <br /> SINK SERVICF-BAR.ETC.) WOODSTOVE/FIREPLACE INSERT <br /> 9UB T0711L SUB TOTAL f <br /> � PENMIT S PERMIT 3 <br /> __ TOTALFEE ! TOTALFEE • _ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FqONISEie�CK FE�RSEIOACN SIDESqE79�CN PUNLHBCN ❑MOER PL�NCNECNFEE ^(� <br /> pZ Q �' U ✓ � �(J �� I> �ll !' FEE a G 9 y3 RECEIPL NO �t'!Vl�� <br /> ( Q V <br /> 113E20NE ��T�AEl1 G�NTSIIE <br /> �.� , 9 ��0 . ES ONO FEES VALII�TION fEE �� <br /> TYPEOFCONST. OCCUPANCYGROUP NO.OFOWEILINOUNIT4 !Vl <br /> �- � R- � / , "_ <br /> eui�oiNo S�p 5 c— ',� <br /> 912E OF B100. � . N0.OF STORIE9 M�K OCG LO�D �pyy <br /> J! �,��T ^' PLUMOIN6 8O yy <br /> MECNANICAL <br /> FIRE SPRINKLERS FE�UIRED ❑YES ❑NO — <br /> OiHER <br /> PENALTV w <br /> �PPUGtION�CC OY P��NSLIIECNEDBV AFP11 FOf1155UANCEBY <br /> � `� � � G ,otA� _ �51— - <br />