Laserfiche WebLink
�� ,,,, <br /> ,�,E„�„�, A'�PLICATION FOR�;:>� ���,�„ <br /> Gry°� CONSTitUCT1�ON e <br /> everett PE RM IT <br /> BUILDING DEPARTMENT <br /> 259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION �➢ COMBINATION ❑ BUII.DING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEP MAIIAD�PE55 CIiY 21P PHONE <br /> � CaFL4MOIZ o��/ELoP 1�ne�.r7' �f211'2ooTN sr.sw . L.`fhk�oor� 98o3b .' �74'� �0 98 <br /> MICNITECTOPOESIUNEfl MAILAD�RE95 CITY 21P PNONE . <br /> G O A 4230 — ! 9F�T'1 s e.0 LYNnw000 �go? G 7'1/-230 0 <br /> OENERALGONTH�CIOH MAIL�O�NE55 Gltt 21P PHONE IICF.NSE• <br /> MECH�NIC�LCONTPACTOq M�IL�OURE53 CITY � 21P Pf10NE tICENSE• <br /> PLUMBINOGONTRACfOR MMI�ODRE55 Cltt ZIP PIIONE UCENSE• <br /> ��o1A1S90F WORK . <br /> 1cy NEW I� ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDINO RELOCATION <br /> WLWTIONOFWORIqCOSTOFM�TERI�LSPLU ABOR� <br /> DE9CRIBE WOPK �,I,,I /� � � . l <br /> -t�htA�-►T' !h�(a2ovE� �1'C�tU� !'tVYl�f�l�/� l. <br /> useoreuanu+o � I HEREBY CERTIF�•THAT I HAVE READ AND EXAMINED THIS AP• / <br /> Wl/.lOSHIELLJ ��PH( �L p�ICATIONANDKI+OWTHESAMETOBETRUEANDCORRECT.ALL <br /> LEO�LDE9CRIPTIONOFPNOPSRtt�9HOWNBELOWORATT�CHFOUflCOPIE51 pqpVISIONSOFLhWSANDORDINANCESGOVERNINGTHISTYPE <br /> iS�Yl�if OF WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHE . <br /> �or_e�ocK_ar . INORNOT.THEGFANTINGOFA RMITDOESNOTPRESUMETO <br /> GIVE AUTHORITY TO VIOLATE OR NCEL THE PROVISIONS OF <br /> �OLLMiQ S OF PLAT'L� PACaE Z ANYOTHERSTATEORLOCALLAWR GULATINCaCONSTRUCTION <br /> OR THE PERFORMANCE OF CONST UCTION. <br /> JNO O G T SIONATU E OF CON ACT R pp Al1THOP1 �6ENT DATE ' <br /> �j {` <br /> ���!'c. T- I ) X :C ��j�/ <br /> PROIECT�U0RE43 PLIC�NTSCI YBUSII.0 LICENSENO. <br /> lO - S� I-r�Ar.� w.4Y q <br /> PLUNSIN� MEC ANICAL <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILE AIR COND.UNITS—H.P.EA <br /> BAMTUB RFFHIGERATION UNITS—H.P.EA <br /> � UVATORY WA9M BASIN� BOILERS—M.P.EA <br /> 9HOWER QAS FIRED AG UNITS—TONNAGE EA <br /> KITCHEN SINKB DISP. FORCED AIq SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALL HEATERS—B.T.0 M <br /> UUNDRVTRAV UNITMEATERS—BT.U. M <br /> CLOTMES WASHER EVAPOMTIVE COOLERS <br /> WATEq HEATER CIOTHES DRVERS <br /> URINAL VENTILATION FAN <br /> DRINKINU FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HAN�LING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DiiRINS—RAINLEA�ERS METAL FIREPLACE 8 CHIMNEY <br /> SINK S:RVICE—BAR.ETC. WOOOSTOVE/FIREPLACE INSERi <br /> SUBTOTAL SUBTOTAL S <br /> PEFMIT f PEHMIT S <br /> TOTALFEE ! TOTALFEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FFONTSETB�GK PEAP9ETB�CK SIOESETB�GK PII�YGHCKNU�Eq � I FEE��NRECEIPfNO.��j�-�(`'( <br /> ��{ �1 <br /> I15E20NE LOTAREA ��, , ` ��� ' <br /> VACANTSITE FEE9 VALU��ION FEF <br /> �� OYES O <br /> TVPEOFC9=9T. OCCUPFNC.GROUP NO.OFOWELLINOUNITS • <br /> T' N B 2 'a- _ <br /> Y• BWLDING S <br /> SRE OF BLQDO. NO.OF 5'OPIES M�IC OCG LO�D <br /> �I�P �F I 'fi PLUMBING �� <br /> MECM�NICAL <br /> FIRE SPRINKLERS REOIIIRED 0 VES O <br /> OTMEfl <br /> PENAL',V <br /> �PPIIC�'ION�^J.BY PLANSCMECNEODY APPR.fORISSU�VLEBY <br /> - ^ 1 � TOTAL 1 <br /> i <br /> V%� � <br />