Laserfiche WebLink
� <br /> ,,PPLICATION FOr� ���,�„ � <br /> ���'°'"° CONSTRUCTION O <br /> everett PE R M I T,- <br /> BUI:DING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION O COM8INATION O BUILOING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> py,.qrp MML�DDAE55 Cltt ZIP P�IONC <br /> �' ' �n �y Ga`dHev 7s"i � ll�aT�er at�a� q�zd3 3�3 398'� <br /> •PCNI FCtONOFSiGHER MUL�ODRE55 Clrv Zlc PNONL <br /> GkNEHM CUNIPIQOR Mell AODRkSS G�rv IIP �'upNE UCENSE� <br /> nu�n�� <br /> MtLH�NiGLCON�N�CIOq MMUOORESS C�Iv PP v��ONE LIC[NSF• <br /> PLUMBMl1CONiR�G10R M11L�DORE55 C�TY IIP PIIONE IIGkNSE� <br /> CU550�WOAK <br /> ❑ NEW ❑ AODITION ❑ ALTERATION ❑ REPnlfi ❑ OEMOLI110N ❑ WOODSIOVE/FRPL.INSERT ❑ 6UIl 1 G t�l�j� <br /> V�W�I�ONOfWORKICO510fM�IERi�l5PW5L�BOn1 _ _ _(Y; <br /> y,� u /-��a�i`1i��22 5�'�e/�Va ��t �a-I�d-SPi�G�V 7�`ieeT�BC�C '�r��J` <br /> /orscnmcwoan + �� r -T / <br /> �ool� S�i e e YOG �o 0�5 K /a�l � A'Cous, P� <br /> usc o�am�o�Nc I HEREBY CEP.TIFV THAT I HAVE FEAD AND EXAMINED THIS AP <br /> � PLICATION AND KNOW THE SAME TO BE TRUEAND CORRECT.ALL <br /> LEWlDESCRiPtiONOFFR0�ER1Y�5MOWNBELOWON�Ii�CHfOURCOPIE51 ppOVI510NSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE� <br /> ioi_eioc�—or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TC VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIGNpTURE OF CON7RACiOR OF AUTNOR12E0 AGEN7 ❑ALE <br /> X � �- z 87 <br /> VAOIECT�DURESS �PP�ICANTSCItYBUiiN SSL�LENSENO <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMEN7 FEE <br /> W�TEP CLOSET�TOILET) A/C—AMNDLG UNITS—H.P. <br /> B�TNTUB FEFRIGERATION UNITS—M.V.EA. <br /> � UVATORY�WASH BAS�N� BOILERS—B.T UlH P. <br /> SMOWER GAS FIRED A.C.UNITS—B T.U. <br /> KITCNEN SINK 6 OISP. FpRCED AIR SYSTEMS—B T.U. M EA. <br /> OISHWIISHER WAILHEATERS—B.T.U. M <br /> UUNOflV TRAY UNIT HEATERS—B T.U. M <br /> CIOTHES WASHER EVAPOHATIVE COOLERS <br /> URINAI CIOTHESORYERS <br /> DFINNING FOUNTAIN VENTILATION FAN <br /> FLOOR�RAIN AANGE HOOD <br /> BACKFLOW PFEVENTERS WATER MEATER <br /> ROOF ORRINS—RAINLEADERS WOOD STOVE <br /> SINK�SERVILE—BAR.E7�.) METAL FIREPLACE 8 CHIMNEY <br /> FIFEPLACEINSERT <br /> HEAT PUMP <br /> GAS P�PING <br /> E%HAUSTFAN <br /> SUBTOTAL f � � SUBTOTAL <br /> CERMIT S � PfRMIT <br /> TOTAIFEE f TOTALPEE <br /> ��UNISEIB�f,M PE�FSEIBACM SIOESEIB�CK PIANCMECKNUMBEfl IFEE FECEIFTNO. <br /> useaor+e wrenee �������sue FEES VALUATWN FEE <br /> ❑YES ONO <br /> euaowc 5 <br /> �vP[O�COI15� OGCUFANCYGPOUP NO.OFUWELLINGUNiiS 1�7 <br /> PLUMBING `p <br /> SilE Of BLDO NO Of Si0PlE3 MAX OCG LOAO <br /> MECHANICAL <br /> OTHEH <br /> FIRE SPRINNLERS FEOUIRED ❑ YES ❑ NO SiATE BUIIDING�URCHARGE <br /> STATEENERG"SURCHARGE <br /> GPVII�R��ONA[(,' BY P�ANSCHECNEDBY RPPR FOf11SSUANCEBV <br /> PU9LIC WORKS <br /> C � TOTAL <br /> PROPERTV OWNERS ARE FESPONSIBIE FOR DETERMINING ALL <br /> PROPERTY LINE LOCRTIONS AND RELAIED EASEMEN7S. <br />