Laserfiche WebLink
� <br /> r � <br /> `'APP�.ICATION FOR ��«P„ <br /> tMErapr�M CONSTRUCTlON e <br /> GITY OC <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION � BUILDING ❑ 1dECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER M�IL��DPE55 CrtY LP PUON[ . <br /> uul� al� to c � ' t9o/ wF N A�f SEA�7�E� _9!'rt/ 223-7�'LO <br /> 11aCNITECTORDE510NER . �� M��L�O RES�� �� �� �����`_ ��O� /��-����� �,�� <br /> N E sctiwiDT ro r " � <br /> 6ENEMLCONTR�CTOR � M�ILAOORE55 � GILY 21P , 7 LIGENSE <br /> MEGNANIL�LCONTMCTOq MAILADORE55 GItY ZIP PNONE LUENSE• - � <br /> VLUMBINQGONTRACTOR M�IL�DDNE55 CIfV 21F PMUNE IIGENS[• <br /> CL�55 OF WOAR y <br /> � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR �q DEMOLITION ❑ WOODSTOVE/FRPL.INSERi ❑ BUILDING RELOCATION <br /> I WW�iION�cW�N�SoFOMATOERUIL5PW5lABOR1 — <br /> DESCRIBE WORI( <br /> �tr'MouF tk�tTluG s'�1�c6 snlr�en►. co�rsrN��r NFw sAcv. ,ttr. �tNsE rM�Ks o <br /> -� <br /> � USEOFBUILDINO �./� � <br /> 3E�� a 1 nT��AJ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TI{IS AP• � <br /> PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL m <br /> ���� LEWLOESGRIPTIONOFPROVERttISNOWNBELOWORATT�CHFCUNCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE " <br /> i OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE <br /> tot_a�oc�_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO .... <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF --�"*� <br /> ATTACI��D ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION ..-1 <br /> ' OR THE PERFORMANCE OF 'ONSTRUCTION. �^m <br /> SIGNATURE OF CONTRRC�OR 1 ILE�AGENT DAIE C 0 <br /> X ' �//tllrY �_ <br /> O 3 <br /> PROJECT�pOAE55 / �PPLiG/N�SCI USWlSSLIC[NSEKO m <br /> 2.io2. !'Il��'{��� �V� m .. <br /> ( PLUMBIN6 MECHANICAL _ - _ _ '�Z <br /> I NO. T/PE OF FI%TUHE FEE NO. TYPE OF EOUIPMENT �_ FEE � _ <br /> WATER CLOSET TGILE V O AIR COND, UNITS-H.P.EA. � w '�""' <br /> --i N <br /> ,I AqTHTUB REFRIGERATION UNITS-N.P. EA. K T <br /> � L�VATORY WASH BASIN 4D BOILERS-li.P.EA. O .'D� <br /> � SHOWER GAS FIRED 0.C.UNIiS-TONNPGE EA T j <br /> KITCHEN SINKd DISR FORCED AIP SYSIEMS-B.T.U. M EA. �m <br /> S <br /> DISHWASHER WALL HEATEHS-B.T.U. A1 ���J y� m N <br /> UUNDRV fRA� UN-T NEATERS-B.T.U. M O r <br /> �LOTHES W�SHER EVAPORATIVE COOLERS C N <br /> WATER HEATER CLOtMESORYERS �N <br /> 'm <br /> URINAL VENTILATION FAN �� <br /> �RINKINO FOUNTAIN RAI:GE HOOU • Tn <br /> FLOOR DRAIN AIR NANDLING UNIT- C.F.M. __ ,� <br /> VACUUM BREAKEPS STOVE _ � <br /> FOOF DRAINS-RAINLEADEHS METAL PIREPIACF.B CNIMNEV_ __. _ __.____ _ <br /> D <br /> SINN SERVICE-BAH.ETC. WOODSTOVE/FIREPLACE INSFRT ____ __ Z <br /> I —_ -_ — � <br /> _ —— _ <br /> .-. <br /> —-- N <br /> 2 <br /> SUB TOTAL SUfl TOTAL f �� �� O <br /> PEqM1T t PFRMIT S _ _ _ m <br /> TOTALFEE i � TOTALFEE S � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. P�RSONNEL <br /> f00NTSETBACK NFARSETBAGK 5iPE5LiB�CK PUNCNCLnNUMOER PLANOICCnlLE <br /> . ��� � I�Q� (F[ af� RC�IPI� . 0 <br /> 3"� �-�- <br /> USE20NL LOT�REA WC�NiSrtE <br /> FEES V�LU�TION FEE <br /> pYES ONO -- <br /> TVPEOFCON51. OCCUP�NCYGROUP NO-0FOWELLINGIINIiS <br /> � i 1 �Q� } <br /> �' �.� � . IV�Y OUILOING �p,7�O _ J� _ (� <br /> SiLE OF BLOC NOAF StOPIES M�X OCC.10�0 — <br /> � 3'72 5.� I NA PI.UIdBING ___¢ �C� <br /> �� MLCHANICAL �{/ � <br /> FIRE SPRINKLERS REOU�RED ❑VES ['l NO <br /> OTN[R <br /> PENALTY <br /> �PVLIGTiON�CG.BY PUNS CNECNEO BY APPR.FOP ISSUANGE BY �y �y� <br /> TOTRL "J' a 2' �61 <br /> �,, , ;: L • c . <br /> f �rT' <br /> I <br /> i <br /> � <br /> _ � - <br />