Laserfiche WebLink
APPLICATIt ] FOF; CONSTFRUCT )N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �'E" <br /> HEATING SYSTEI.1: J GAS J ELECTRIC J -- -- — _ . <br /> BUILDI�JG DEPARTIdENT <br /> 2�5-&d1U � <br /> DEMOLITION COMBINATION BUILDING MECHANICAL �iPLUMBING SIGN <br /> [q � <br /> I.IAIL��ORE55 GTY (" PHO��E <br /> ��1t�'�12 r� � .'� i s�• �r v F✓�',K -r- �i5 -bSl� <br /> .qN' � IAAILADOAESS CRY ZP PNONE <br /> ��CHRECiORDES�GNEP UAILADGRE55 CrtV 2�P PHONE <br /> ; (]'^ GITV ZIP PYONE SiPTELILENSE/ � <br /> �•C•7 d!:EBNLCONTflACTOR AIAI�AppBE55 <br /> �"�a� __ <br /> A�� ��TY Z�p PHONE STRTEI�CENSE/ <br /> oiGHANIGALCONTRPCTOR MAILAD�RE55 <br /> H <br /> >h W <br /> r w VWi�BINGCONTPALTOfl IAAILRODRE55 CiTY ZI�' PHONE STAT[LICENSE� Il��"-" <br /> ~ a� �.r ���(1 6zoG �>r �yi{iLY3✓�t6 - 9'fl2 O 3�HyG3 "" /'l'�A��' <br /> Kz� �'Y/'A / �>,��I <br /> rl`� CONiRACT PRILE OF WORK <br /> O ~� � CONTACiPER501�AN�PHONEhO <br /> y C4� D%SCRIBEWORN�NOSOURFEGOOTAGE�NVONED � � L� yn�£ —_ <br /> oyc ; ,��rA<c rc�aN �� rc�; N�n�� .�i-,�/ 33H-S�3� _ <br /> H L*JO iC ,fJC�E�%C� � HEREBY CERTIFV THAT I HAVE READ AND EXAMINEG 'iii15 <br /> �� n 2� <br /> H � ,-�:nroseouseocem�o�nc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORF7ECL ALI. <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH'S TYPE OF <br /> �-9i y Z . .:c;ceiatiouoFraoaeervisr+owr+ee�owonnrrncHrvrowPies WORK WILL BE C01dPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> H� NOT. THE GRANTING OF A PEPMIT DOES NOT PFESUME TO GIVE <br /> Oy H . .. e�ocK w — AUTI�ORITV TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br /> � �� O7HER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR?HE <br /> � PERFORIdANCE OF CONSiRUCTION.THAT I AM AUTHOAIZLD 9V THF <br /> � lT1 t" OWNER OF THIS PROPERTV TO PERFORM THE IYCRK FCF �!�I::ia. <br /> zH� APPLIGATION IS MADE AND I COMPLY C/ILf T'���.5 :dT4TC <br /> y p CA .,.. :.� rnx io r+u�.�een COtJTRACTORS LPW 1827 RCV!AND 2962U0 WAC <br /> V TI NL A��LENOE0.AO�RESS.TEIEP��04E1:UVCf❑ . <br /> ,� nR i :� <br /> .�� � ��---4�-L�.-__—_. X- � �J �i��!^r'csG �r1/�r___ _ _. _ __ _ <br /> . ./r_, ont� <br /> PROJECTADDRESS - — -� <br /> PLUMBING MECHANICAL — <br /> ��p, TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ��r' _ _• __ A C-hHNDLG UNITS-H.P. _ . <br /> WATER CLOSET�TOILFT� <br /> �� -- � PORCED AIR SVSTEIdS-B.T.U. M E.A. <br /> BATHTU6 _ <br /> � LAVATORY IH'ASH BASIN� UNIT HEATERS-B T.U. M <br /> '�` SHOWEF7 _ CLOTHES DRYERS <br /> v� KITCHEN SINK 8 OISP VENTILATION FAN <br /> DISHWASHER _ RANGE HOOD _ <br /> LAUNORY TRAY WATER HEATEfi - <br /> CLOTHES WASHER WOOD STOVE <br /> -w� IdETAL PIREPLACE(WOUD BURNINGI . <br /> URINAL -- — <br /> DRINKING FOUNTAIN FIREPLACE INSEfiT <br /> FLOOR DRAIN HEAT PUMP _ <br /> �� O� BACKFLOWPR[VENTEHS GASPIPING . <br /> ROOF DRAINS-RAINLEADERS _ EXHAUST FAN . <br /> SINK(SERVICE-BAR,ETC.) — -� <br /> �� r' — _ _._ <br /> —�- <br /> �_. ,�.. SUBTOTAL 5 ' ��' SUBTOTAL 5 ,. <br /> � � PERMIT 5 �{Z G PERMIT S _ <br /> - �� � TOTALFEE 5 '� TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> - — � ���I;d1S(1pACH —����� "::If)ESET�ALK �LANCIIFCetlUMllf.�i fCl RECEIPTNO <br /> .. n::t roncn � <br /> .,,,��� -- -i���;,���� vpcnr�Tsrte FEES VALUATION FEE _ <br /> � i YES �.�i NO pi�i�DwG ___ _ <br /> — �_- <br /> �.i.�cousr ��o ov sroAies ir.crue. w�rv owia:w�u.,�s ---------- -- <br /> cnoav PLUId01NG _ <br /> .. cF�LOG FIRESPNiNNLEI{SREOD BAS[MENL IdEGHANICAL ._ <br /> : vEs Nn <br /> � �. iPANGY IOAp FIRE AUPM R[OD II[IGIIT LIMRAIION AD�ITIONFL PLAN CHECK � . <br /> I <br /> " ___—_ _ " __ .— OTHER � _ � <br /> c:nr� <br /> S7ATE�UILOING SURCHAPGE _ <br /> , �..� py PUNSAPPROVEOBY I CITYOFEVERETT P7FLICWORKS <br /> LOC11L SIILES <br /> � TAX C(lQE iS 3105 TOT^� <br /> --- _—�_ <br />