Laserfiche WebLink
/�.. 1 <br /> ..PPLICe4TlOfo1 FO.� ,.��,�„ <br /> '°'F�"°"'° C0�9STRUC�ION <br /> C�TY OF � <br /> everett PE�MIT <br /> TO BE COMPI.ETE� IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. �L <br /> 259•8745 'K 1 CQMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> !ti <br /> p�yq[q AIAIL AO�FESS CITY 21P PIIONC <br /> �r��;,� �i� r?ss��rG7��" �r7�5 ;���! �?�I�' IJr3 .Se� (,�,tF 9�P//s 5��-ao rfs_ <br /> �flCluIECTOR�E5IGN[9 MAILAOOHESS GIT! ZiP � PIIOI![ <br /> GlN[t14CONTfiRCIOR MAILADDflE55 CITY 21P PIION[ UCENSE• <br /> l i <br /> �rl�t C <br /> �1.C11/.NILAICONiPAC10fl MAIL40�FE55 Citt ZIP P1101lfl LICENSE� <br /> PWFIOiNGCONiRACiOR MPIL�O�fl[55 CIN 21P PM011E LICENSE� <br /> SS OF WORN <br /> � NEW ❑ ADDITION � A�_TERATIOIJ ❑ REPAIR ❑ DI:MOLITION ❑ WOOD3TOVE/FRPL.INSEFIT ❑ BUILDING RELOCATION <br /> �WLUAIIpNOFWOlINIWSTOFAI�t[ InLSP,-0SLIBOP� <br /> ��p/� 7 SZX��('x� <br /> oesci7�oe wonK <br /> %��A� �{v�{'(Lt)✓H"1'�l[�' P. - �F - C��-r(�YL <br /> USC Of UUIIDiNG <br /> I HEREBY CERTIF`!THAT I HAVE READ aND EXAMINED TI115 AP� <br /> PLICATION AND KNOINTHE SAME TC 6ETFUEAND CORREC�I.ALL <br /> lEG4l0E5CRIPiIO:IOFaROPEflTY15M01YN8ElOWOflATTALHFOUPCOPIES� PRO'�/I�IONSOFLF,WSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETEU WiTH WI IETHER SPECIFIED HERE- <br /> �or—eiocK—or IN OR NOT.TH�GRANTING OF A PERMIT DOES NOT PflESUME TO <br /> GIVC AUTIIOFITY TO VIOLATE OR CANCEL THE PfiOVIS10NS O� <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> — OR THE PERFJRMANCE OF CONSTflUCTION. <br /> SIGNATUflEO'CONTRqGtOBOflAUTMORIZEO? .ENT DATE <br /> X l�w S /L � <br /> FBO'2CIAGOFE55 S'/�G�� O APPLICRNiSCIIYUU51 - LL'LNSENO. <br /> � <br /> /a03 S,G. �✓� � w�.G u�l- <br /> PLUMBING MECHANICAL _ <br /> NC. TYPE OF FI%TUN6 FEE NO. TYPE OF EOl11PMENT FEE <br /> 1YATER CLOSET(TOILET) AIR COND.11NITS—H.P.EA. � <br /> BATHTUB REfRIGERATI(1N UNITS—H.P.EA � <br /> LAVATORV(WASH BASIN) BGILERS—HP EA. <br /> SHOWER GAS FIRED AC.UNITS—TONNNGE EA <br /> NITCMEN SINN fl DISP. FORCED AIFl SVSTEMS—B.T.II. I1 EA. <br /> DISIILYASNEf7 WALLHEI.TERS—B.T.U. M <br /> LAUIIDCYTRAV UNITHEATERS—B.T.U. M _ <br /> CLOTHES WASIIER EVAPORATIVE COOLERS <br /> _I N'ATER HEATER CLOTHES DRYERS _ _ <br /> t _/ VENTILATION FAN _� <br /> URINFL <br /> DRINKING FOUNTAIN FAPIGE HOOD <br /> FIOOR DRAIN � AIR HANDLING UNIT— flF.A'. _ <br /> VACUUM 9REAKERS STOVE _ <br /> ROOF ORAINS—RAINLEADERS METAL FIREPLACE 8 CHIMNEV _ <br /> SINK�SERVICE—BAF.ETC.1 WOODSTOVE/FIREPLAC�-INSERT <br /> T G�.»,✓ .3Tv ��� <br /> --+ ---- <br /> _ SU9 TOTAL Sll9 TOTAL S `1 S�O <br /> PENMIT S PEHMIT �l � <br /> TOTAL FEE 5 TOTAL FEE S I _�It2t1_ <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FflONTSEif�4CN REAHSET�ACN SIO[SETBACN PLANCHEGHNUMb[F {F-I�}ANCHECNfEE <br /> �. I.� � ��� FEE �L/� RE[E�1��� <br /> Y� <br /> ❑SEZONE LOIAHEA ypCANT5ITE yp�pqTION FEE <br /> FEES <br /> �.. � a .a , oY�s ,�o <br /> IIP�EO-JF�GONST. OCNP�ANC^YGFOl1P NO.OFOWELUNGIINITS A•, __ <br /> �Y�.�� •' �` � BUILDING S�'f� �'(,J (1, '� <br /> 512E OF IiLDG NO.OF STOHIES M�%.00AQ lOAO l � t <br /> I��O !,r ( �� — PLl11.IBING _� � <br /> 5�� �� <br /> MECHANICNL q Q� <br /> FIRE SPf71NKI.EFS HEOUIRFfi ❑YES jq NO _ <br /> — OTHER <br /> PENALTV <br /> APP � TIONACC.OY PLnN5C11EGKEDBY P'�P �Jfl'SSUANCEBY �— <br /> � T0T4L <br /> �_ k.. � G <br />