Laserfiche WebLink
iAPF�LICATI� FLR CONSTRUC'3�N PER�1A14 �� <br /> TO BE COMPLE7E0IIJ BLACK INK-PLEASE PRINT ��� <br /> , . .. . . _ .. . . . . - 1 <br /> , HIPA�iI��GSY5T6�A� �GAS JELECTRIC J . 'i <br /> LUII D1NG DEP�RTM[NT - � <br /> '___—_- _——__-_. -.- . _. .. <br /> .,�.; ��.:il0 <br /> _. <br /> DEIdOLITION COMBINATION BWLDING . MECHANICAL PLUMBING _ _ SI <br /> �.,.,oc�, �� —_ /�(Dd(o ,�*J(c��LE���(J I.�i(�4'� �'�=_c7 J%� <br /> �,u�.��� ,�s,���_ �_ <br /> _, „��,,���� , ��.. ��• - , ���, <br /> ..':CiORO(S�GNEP AIn�E00R65 CILV 21P PIWNE � <br /> �, M��qYiFACtOP M4lP�DflESS CIIY ZIP PtlQ4E SiQEULfNSE• <br /> �� �� — PrrcmE srnciicExsE. <br /> .. _„„rnicorunacioa n�nneooncss crtv nv <br /> T�'NGCq1IB�CTOF MML�OOPE55 C�IV ZIP �NONE 51�1ElICENSEI <br /> .,�b�Li PO�LE OF KOPK <br /> ",�,cL N9�N AND SOU�AE PWT�G[INYJIYE� CGNLACt PEPSON�ND VIqNE NO <br /> :..�/_E.LADa�C � iYL� cU �� ✓ --- <br /> I HEREDV CERTIFY THAT I NAVL flEAD AND EXAMINED THI': <br /> :,seDuSEoc am�mNG APPIICATION AND KNOV!THE SAIdE TO BE TRl1E FND CORREGr ALI. <br /> PRGVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYP[Oi' <br /> n_�Eunirnaxov�ao�caiv�seon++ee�owonnrtnc��rrvocovi[s N/ORK WILL BE COMPLETED W�TH WHETHCR SPEQRLD HEREIt!C9 <br /> NOT.THE GRANTING OF A PERMIT OOES NOT PRESUME TO�+i�'b <br /> . ea:trc-- � pl)THORITV TO VIOLAT[ OR CANCEL THE PROVISIONS OF AN`: <br /> OTHER STATE Ofl LOCAL LAW REGt1LATING CONSTRUCTION O�7 HE <br /> — PERFOR�7ANCE OF CONSTHUCTION.THFT I AM AUTHOFRED BV THE <br /> O�VNEfl OF THIS PROPERTY TO PERFORM THE WOFK FOR WIIiGI <br /> APPLICATION IS tdADE ANO I COMPLV WIiH iHE SiAri_ <br /> � -'. .uzioNuu9Ee GO'vTRACTORSLAW182]RCWAND29fi200Wi,C,. <br /> � ic:ior+�onrv�cNoea.nooness reio oi+=_im�.��eu /] 3 <br /> J l�. <br /> —-- E.i��� _ __ '�,f.d������_ _._. <br /> PROJECTADUflESS � ' - —� <br /> .>�1%(� �I�4�Cl.l� _— _ — <br /> PLUMBING 1dECHANICPL <br /> 1lD. TYPEOFFI%TUREOflITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATIER CLOSET I10RETI __ %��--�HNOLG UNITS—H R __ <br /> BATNTUB PoaCEDAIRSVSTE1dS—BTU. M EA. ' <br /> LAVA70iiV�WA5H8A51N�� UNITHEATERS—BT.LL �d ___ <br /> $HOINEF CLOTHES�RYERS <br /> KITGHEN SINK fl�ISP VENTILATION FAN __ __ <br /> DISH`NASHER RANGE HOOD <br /> LAUN�FY TRAY WATEF HEATER _ <br /> CLOTNES W�SHER WOO�STOVE <br /> UfiINAL IAETAL FlR[PLACE�WOOD BUflNING) . <br /> ORWM;ING FOUNIAM FIREPLACE INSEflT _. . <br /> FLOOR DRAIN HEAT PUMP _ _ . <br /> BACKP�OW PREVENTERS G4S PIPING _ <br /> flOOF DFAMS—RNNLEADERS EXHAUST FAN _ <br /> SIt�K�SERVICE-0AR ETC.I - �— <br /> SUB107AL 5 ___ SUBTOTAL 5 _' <br /> .._..-- —' '— PERMIT 5 __'__ PERMIT _ _ _ <br /> --. .._.. --"—TOTALPEE S �-- TOTALFEE- - ' <br /> FOR OFFICE USE ONLY: <br /> , � urna�sunnc.x smes[iencK vumcu�.rn:eieu ru. mce�rina <br /> I � �. <br /> ., �� in�mun v�aw*snE FEES l VALl1ATION FEE <br /> .�. VES .-, NO �w�ort�c; ', <br /> r NOOFSTORIE3 . . ... . � � � <br /> �.�.:pN51 rcCV�M1Cr Md'JmiIYUGUx.•S <br /> •.a PLLINOiIJG <br /> .;�g�pp FPESPRnlvLEN5FF0� R/.SE�JENi MECHANICAL . �.. . � � �� , <br /> ' YES - NO — . . .---,- <br /> �.•nNcrin�o rwEAunHPE�o I, nr��;�u�.�,�,;mvq AooliloNntPLANCHLCr _ . _ f <br /> OiHER <br /> __ - . _ . . _ . . __._ <br /> SiFiIE OUIl01NG SURCNAtVGF <br /> , � t :.•."..� .��.�b-r. ' GITY OF EVERETT nunuc einnKs - __ _ — - .. <br /> �ocnisni-Es <br /> rnx cooF is 3ios r���� <br />