Laserfiche WebLink
'l_� ['%I <br /> fhsEwrprwn CONSTRU�CTION,�`a <br /> an oc <br /> everetl <br /> everett PERMIT e <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259-8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MRI�AD��E^5 G�rv ZIP !vl@IF <br /> �m_mfl-�-��+ 15o2lrc�mbArd tvE�-�t� 9u�o� �sa-nn� <br /> �RCIIITECtORpE IGNER MAILROOfiE55 Cltt zip prypryE <br /> GENEfIRICONiP�CTOR MRILApDRE55 CIIY Dp vNOt1F UCEuSE• <br /> kv��-e�-4�►-s.�e.�Q(��itQ�es�p e3�1 48aaa �s3-h11a1 <br /> MECNANICALCONTR�CTOq MAI�AD�fF'� Cltt ZIP IOIONE �ILENSE• <br /> �a3-ol- v�.R�'s �3oiP+�- <br /> PWMBINGCONTR�GTOF MM��D:"" . � �Irv ZiP PuONE LiCENS[• <br /> CUSE OF WORN y <br /> ❑ NEW ❑ ADDITION LJ ALTERA710N ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING FiELOCATION �5 <br /> VALWiIpN O�WORN�COSI OF M�TERIALS PW$LABORI � <br /> �o��o�. OU ��", <br /> �ES RIBE WORK • •• <br /> � i111, � \c�1 n1 . � <br /> USE OF BUILDI G <br /> I HEREBY CERTIFY ThIAT I HAVE READ AND EXAMINED THIS AP- <br /> PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL H H <br /> I.EGALDESCFIPt10NO/FP�ROPEPTY�SHOWNBELOWOP4RPGNfOURCOPIES� PROVISIONSOFL/�WSANDORDINANCESGOVERNINGTHISTYPE '-3 ^7 <br /> �oT_e�ociOEloN,v OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- H <br /> INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO � � <br /> /1(„� JIk� GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF � <br /> VC 1 I _ / O / ANY OTHER STATE OR LOCA�LAW REGULATING CONSTRUCTION <br /> ry J! � O�r �Jt �) 9-` R�I .�[Jt. � OR THE PERFORMANCE OF CONSTRUCTION. . <br /> $IGNA7UREOFCONiRACTOROPAUTNOFl2[OAGENf OAIE �7SI��,S � <br /> .— � <br /> L �i' �`. / [�. 7T �l�/ L /.�( /��� / /�� � . <br /> 5 - 1�-�I -ocna-� � �� °-��, , , � ., .v � � <br /> PROJECi�pORE55 APPUCANiS 'IIY�USWESSIICENS[NO � � �- p z <br /> � � <br /> H H <br /> PLUMBING MECHANICAL K y <br /> NO. 7YPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE O � <br /> WATER CLOSET(TOILET) AIR COND. UNITS—H.P.EA. � <br /> BATHTUB qEFRIGERATION UNITS—HP. EF. � <br /> IAVATORY�WASN�ASIN) BOILERS—H.P.EA. H <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGG E0. � <br /> KITCHEN SINK d DISP. FORCED Alfl SYSTEMS—B1.U. M EA. r+ <br /> DISHJJASHER WALL HEATEqS—B.T.U. M Uj <br /> LAUNDRVTRAV UNIiHEAiERS—B.T.U. id � <br /> CLOTHES WASHER EVAPORA7IVECOOLERS . � <br /> WAIER NEATER CLOTHESORVERS <br /> URIW\L VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD � <br /> FLOOH DHAIN AIR HANDLING UNIT— CF.lA. <br /> _ VACUUM BREAKERS S70VE <br /> ROOFORAINS—RAINLEADERS AfETAIPIREPLACEB CHIMNEY �y <br /> SINK SERVICE—BAR,ETC. WOOOSTOVE/FIREPLACEINSERT N <br /> — — H <br /> H <br /> _ � <br /> I9 <br /> SUBTOTAL SUB TCTAL 5 <br /> PERMIT S PERMIT 5 <br /> _ TOTALFEE S TOTALFEE 5 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FpONi5ET8RCK FEFRSEiBACK SIDESEi�RCN PLANGRECHNUhIpER PlANO1LC�FCE <br /> �EE i�ECEiPI NO <br /> t15E ZONE LOT�RER yA�qNi SITE <br /> ❑�ES ONO FEES VRIUI.TION FEE <br /> ttPEOFCONST. OCCUPANCYGROVP NO.OFOWEILiNGUNrtS <br /> BUILDING S <br /> SiZE OF 9L00 NOAF STOR'.ES MA%.p�C.LOAD <br /> PLUMBING <br /> M[CIIANICAL _- <br /> FIRE SPRINKLERS REOUIRED ❑ VES ❑ NO __ <br /> O7HER <br /> PENA�Iy <br /> A�PLICAtIONACC 6Y PLqNSCHECNEDBV PPPq iOFISSUPNCEUY <br /> TOTAL ' -- ------"_— - <br />