Laserfiche WebLink
,;:i;t� <br />`i�PPLICATION EOk� <br />,".E"",°,"" COf�STRUCTIUN <br />an oF <br />everett PE RM IT <br />BUILDING DEPARTMENT ' <br />259-8810 TO BE COMPL@TED IN INK- PLEASE PRINT <br />❑ DEMOLITION Z] COMBINATION ❑ BUILDING ❑ MECHANIGAL <br />_.....__ AIFILPJOqE55 GIiY ZIP <br />MNL <br />���l�-�1�-1r1 E";� f7a7 '14 y�. 1��� t�'. ��-� <br />GNANIf,4LCGNiHPGiOq I.UILBOOf1ES5 LILY <br />PWMpI11GCONIRACiOF AULLAD�tiE55 Gltt <br />ZIP <br />nr <br />everelt <br />e <br />❑ PLUMHING ❑ SIGN <br />PHONE '.caN �1( <br />1' <br />C.tit�n iSt4�31C:}- �fH'00 <br />' PHONE (SP� 36Q-Oi(� <br />1�-rCal iI44i•/G;- Pr,u�..`,Eaµe5E <br />PIIONE � W NBO�II I Jy �7 <br />;�ea�s 3S'i-Gg33 <br />r'HONE LICENSE • <br />P��ONE lIC[NSE � <br />CL4550F WORN <br />rl r.icw I� aooITION � ALTERA710N ❑ REPAIR ❑ D[MOLITION ❑ WOODSTOVE/FRPL.INSERL ❑ BUILDING RELOCATION <br />�n t..'t � L�f�� ��l'�uo � \ r. \�S_ <br />USE Of pU1lDING • <br />c � ��. � � ��.�-1� ��i <br />.��..,.� ionnr [aanncntVi9HOWN�ELOWORAIiiCNfOURGOFIE51 <br />PROJEGi <br />PLUMBING <br />TYPE OF FI%TURE OR ITEM <br />WATER CLOSET�TOILET� <br />BATMTUB <br />LAVATORY�WASMBPSIN� <br />5MOWER <br />KITCHEN SINK 8 OISP. <br />DISHWASHER <br />LAUNORVTFAV <br />CLOTHES WASHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DFAiN ' <br />BACKFLOW Pf7EVENTERS <br />ROOF DRAINS — RAINIEADERS <br />SINK �SERVIC`c — BAR. ETC.) <br />VRONi$EiBACN <br />l <br />UcE <br />SUBTOTAL <br />AENMIT <br />TOTALFEE <br />RSETOACK <br />r <br />f <br />S <br />❑YES <br />I HEREBY CERTIFY THAT I HAVE RE�D AND EXAMINED THIS AP� <br />PLICATION AND I<NOW THE SAME TO BETRUE ANDCORRECT. ALL <br />PROVISIONS OF LpWSAND ORDINANCES GOVERNINGTHISTYPE <br />OF WORK WILL BGCOMPLETED WITH WHETHERSPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERYIIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE GR CANCEL THE PROVIS�ODlS OF <br />ANY OTHGR S7ATE OR LOCAL LAW REGUTATING CONSTFlUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNATURE OF CONiRACTO� OR AUTHOR12EO FGENT pATE <br />� / / �.�l /1 lll/..�n �_f�-R'R� <br />OUSINESS IIGEelSE NO <br />MECHANICAI <br />FEE NO. �rreoreuuirmen� <br />A/C — A/MNOLG UNITS — H.P. <br />REFRIGERATION UNITS — M P. EA. <br />801LERS — B.T.LL/H.P. <br />CA3 FIRED A.C. UNITS — B.T.U. <br />FOF7CEDAIRSYSTEMS—B.T.U. MEA. <br />W�LLMEATERS—BT.U. M <br />UNITMEATERS—B.T.U. M <br />EVAPORATIVE COOLGRS <br />CLOfME5ORYERS <br />VENTIIATION FAN <br />nANGEHOCO <br />� WATER HEATEfl <br />WOO�STOVE <br />METnL FIREPLACE d CNIMNE� <br />FIR!'PLACE INSERT <br />� HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />JFCONSt OGCUPANCYGROUP NOOFOWEI.LINGU <br />JlL- N �3 -2 '�" <br />)�f" BI OG. N0. O� STORiES MnX OCC l�Dj4D <br />�{f �a 5F � 2 C. <br />PV.NSCHECNEO UY <br />� <br />�PPR. FOA �55 W NCE oY <br />� <br />SUB TOTAL <br />PEAMIT <br />TOTALFEE <br />nN CHE K NUMBER FEE � 1 <br />9�� l�ig�� I �"% <br />�ee <br />RECEIFT NO. <br />����� <br />FEES VALUATIO� <br />BU�LDING g <br />PL'JMBING _ <br />MECHANICAL <br />OTIIER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHnRGE <br />PUBLiC WORKS <br />TOTAI <br />PFOPERTY OWNEFiS ARE RESPONS�BLE FOR �ETERMINING ALL <br />PROPERiY LINE LOCA710NSAND RELA7ED EASEMENTS. <br />