Laserfiche WebLink
�- <br />- ,,��.�,��,�,�.�.,� �t�NSiF�UCTfO�, <br />���. �. <br />s.ry�1�1.A. PERM�T PERMIT NO• �-��'"�" <br />CITV IiALL 259-8715 <br />EVERETT.N1A9B201 ❑ COMBINATIUN ❑ BUILDING ❑ MECHANICAL PLUMBING <br />OLVNEH MAIL A��RE55 <br />CITV 21P PMOIJE <br />Mary Serrais 46�7 Hoyt �verett 982�3 PHON259'7978 _ <br />AFCHITEf,T OR �ESIGNEP MAIL /ODRE55 <br />Cliv ZIP <br />CITY ZIF P�IONE LICENSE N <br />GENEFAL LONiRACTOR MAILA�ORESS 1� <br />"S <br />MEGHANICAL WNiRACTOR IdAIL AD�RE55 <br />GTY 21P PHONE LICENSE u <br />PlUM01NG GONTRFGTOR MAIL ADORE50 <br />LITY ZIP VMONE LILENSE M <br />Same <br />Rq55 OF \VORR <br />❑ tIEW � ADDITION ❑ AL?ERATION G�.�EPAIR ❑ DEMOLITION O FENCE ❑ SIGN O WOO� STOVE/FIREPLALE INSER <br />5 <br />UESCRIBE WORK <br />Replace existing plumbing <br />LEGAL Drc <br />LOT __BLOCK �_OF <br />J06 AD�RE55 <br />4607 Hoyt <br />PLUMBING <br />N0. TYPE OF FI!CTURE OR ITEM <br />J, WATERCLOSETQOILEn <br />], gqTHTUB <br />1 LAVATORY�NASH BASIN� _ <br />SHOWER <br />1 KITCHEN SINK S OiSP. <br />1 DISHWASHER <br />LAUNDHYTflAY <br />j_ CLOTHES WASHER <br />1 WATER HEATER <br />URINFL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />`DF DRAI?l5 — RAINLEADERS <br />� SRJK (SERVICE — BAR, LTC.) <br />TOTAL <br />TOTALFEE <br />OF <br />� APPROVALS <br />1. FNVIRONMENTAL CHECK LIST <br />2. BUILDItJG PLANS _ <br />3. FIRE IIYDFANT <br />4. FIR[ PROTECTIOt7 SYSTEM <br />L GRADING <br />5. DRAINAGE <br />7. ENVIFONMENTAL IMPACT STATEMENT <br />d. HEALTH DISTFICT <br />APPLICATION ACC. dY PLANS CHE <br />FEE <br />I HEREBY CERTIF`� THAT I HAVE READ ANC EXAMINED THIS <br />CORRECTIUALL PROV S ONS OF L.�WS AND O DRNANCES <br />GOVERNING THIS TYP' OF WORK WILL BE COMPLIED WI?H <br />WHETHEIi SPECIFIEC IEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTriOnITY TO VIOLATE <br />OR CAMCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF COVSTRUCTION. <br />SIGNATURE OF GONTRACTOR OR I.UTMOPIZE� AGENT [�: TE <br />., �nn' c� .�' . . 12/z7/a3 <br />MECHAIJIr,pL /-1 _ _ <br />` 1— <br />NO. TYPE OF EOUIPtdENT <br />hIR COND. UNITS — H.P. EF. <br />PEFFlIGEFIATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIFl SVSTEMS — B.T.U. M EA. <br />yyALL HEATEi1S — B.T.U. M <br />UNIT HEATEflS — 0 T.U. M <br />EVAPORATNE COOLERS <br />CLGTHES DRYEPS _ <br />',ENTILATION FAN <br />_�FVNGF IIOOD <br />AIF 4ANDLING UNIT — C.F.M. <br />STOVE — NlOOD _ <br />METAL FIPEPLACE 6 CHIMNEY <br />rIREPLACEINSERT <br />HEAT PUMP — <br />s 14 00 <br />S <br />5 <br />iEAR YARD SETBACK PLAN <br />/ACANT SITE <br />YES NO <br />SUB TOTAL <br />PEFIMI7 <br />TOT,9L FEE <br />FEE <br />FEES I VALUATION <br />�UIL�ING 5 <br />PLUMfiING <br />MECHANICAL <br />OTHER <br />FEE <br />� <br />S <br />S <br />CHECK PEE <br />RECEIPT NO. <br />FEE <br />1% �� <br />_ PENALTY SEC. 303 �3) <br />TOTAL li OO <br />PERMITVALIOATION ���� r�p N� ,(y,� <br />WHEN PROPERLY VALIDATED (IN THI � THIS 1 �y0 P S�MIT—� ;�.::J <br />r�• <br />��; �^l.�_'1 �` ' <br />ev 'i '.. '� <br />ADDR:S� FIL"e <br />S <br />