Laserfiche WebLink
,} �$i �� �, i ; : , , i� . <br />,4�'��PLICATION FOR �:; _ `� ���,�„ ,,, <br />�noF°"'" CONSTRUCTION �, <br />everett PERMIT � e ��'� <br />� ,, �:�: <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK- PLEASE PRINT `� '' � <br />254•8810 • � . .� . . <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHAN�CAL O PLUMBING -.� �O SIGN <br />OWIIER Mql�0ONE55 GI�V ZIP PNONE � �:�. �,�� <br />���f f'��,nSi' /yf�� S� C �r�`/Ila/:�1�..�r c��F�`7" -/`�'�703 3�3-c`��oz:._i1 • <br />nne���ec*anoes�arven Mei��oonE55 / . <br />r <br />MMl �OOnE55 / d�-,3 G a.(/u. W ��TM Z�P nPONE UGENSE • <br />ae7�i�eiuiwrnneaon � / � _. . <br />/ % o.,-» %i,.. � C j e 7� 5 % � r � ! � `9 � �nc � ��'>> `� P> 3 � 7 i</ .� � �/ 5 , <br />MELII�NIf:LCOHINILt9� M�ILAD011E55 G�IV 2P 1' ONE LIGENGE• <br />� �lZ D /�/ "T (� n �G{/ <br />s�o �� r��, �,�, <br />__..._..._ _.. .,.,....., uei� ooness c �r zm oHONE uceHsc • <br />;U55 or wof+K <br />❑ NEW ❑ nODIiION ❑ ALTERnTION ❑ nEPAIR ❑ UEMOLItION ❑ WOODSTOVE/FRPL.INSER7 ❑ BUIL�ING REIOCATION <br />��w•�ionoFwo i�s'�f,Mnrt���s�sinnom .. <br />� O <br />T�N��/7 <br />�cT/,f-/L <br />PLUMBING <br />WniER f.LOSET �701LET� <br />BATHTUB <br />U�ATORV (K'ASM bASIN' <br />SHOWER <br />KITCNEN SINK 6 OISP <br />pI5NWA5NER <br />LAUNpRYTRAY <br />CLOTHES WASHER <br />pR�NNING <br />���� <br />i <br />I HER[BY CERTIFY THAT I HAVE RE�D AND EY,AMINED TIiIS AP• <br />PLICATIONANDKNOWTHESA,METOBETRUEANDCORRECT.ALL . <br />PROVISIONS OF lAWSAND ORDINANCES GOVERPliNG THIS TVPE <br />OF WORK WILL BE COMPLFTED WITH WHETHER SF'ECIPIED HERE• <br />IN OR NOT. TI1E CafiANTING OF A PERMIT DOES NOT PRESUME TQ <br />GIVE AUTFIORITY TO VIOLATE OR CANCEL TNG PROVISIONS OF <br />ANY OTHER S7ATE OR LOCAL lAW REGUL�TING CONSiRUCTION <br />OR THE PEFiFORMANCE OF CO`I�fST�RUCTION. .;� . <br />516NATURE O� TB�CTOR Of1 AVJNV'1' E6 AGENT OAIE . I <br />� / <br />X � �` <br />� �/:�,c _- !� �cD <br />ernuce7+rscnrousi E554CENSENO ' ' <br />MECHANICAL <br />OR ITEM FEE ' NO. TYPE OF EOUIPI <br />A/C - A/MNOLG UNITS - H.P. <br />REFRIGEHATION UNITS - N.P. F <br />BOIlERS - B.T.U./H.P. <br />GAS FIREO A.C. UNITS - B.T.U. <br />FOl10ED AIR SYSTEMS - B.7.U. <br />-- WALL HEATEPS - &T.U, <br />UNIT HEATEf1S - B.T.U. <br />ROOF ORAINS - f7�INLEADERS <br />SINK �SEf7VICE - B��. ETCJ <br />SUOTOTAL <br />PERMIT <br />TOTALFEE <br />�uU���5El0�Gn �E�n5E10� <br />USElUriE lOt�qE� <br />fYVE Of CO T OGCUPPNL <br />-N 1 <br />SRE O� OlDO NO OF 31d <br />���� � ( <br />FIf7E SPFINRlERS REOUIREO ,Ip 1 <br />ennn[a�inH�[c nv-�L�NSCIII <br />OVES �O <br />IOUP ��O.OFOWFILING <br />- � �6- <br />$ M�M.00QLOAG <br />:�7'i <br />�� <br />� <br />.,-.... _. .i+. <br />OY <br />CLOTHESDRYERS <br />VENTII.ATION FAN <br />RnNGEHOOD <br />WATER HEATEfl <br />WOO�STOVE <br />METAI FIREPLACE 6 CHIMNEY <br />FIREPLACEINSERT <br />GAS PIPING <br />PLAN CHECN NUMBEN <br />SUBTOTRL <br />PENMIT <br />TOTALFEE <br />IFEE <br />OU7LOING 5 <br />PLUMOING <br />h1ECHANICAL <br />O1HER <br />$TATE DUILDING SU�CHARGE <br />STATEENEFGVSURCNARGE <br />PUBLIC WOfiKS <br />TOTAL <br />M <br />M <br />� <br />RECEIPT, NO. `I � �' , <br />!" <br />FEE' �i <br />�i.: <br />,'''��.',�1. � <br />� <br />� <br />� <br />_ ;� <br />PROPERTY OWNERS ARE fiE5PON5101E FOR DETERMININO ALl <br />PROPERTYLfNELOCATIONSANORELNGDEnSEMENTS. , - <br />,i <br />. . . _. .,'..P�:S'. .. . . .' ... ... . .. . ..i 3 i ... . . __ <br />