Laserfiche WebLink
, <br /> �,E„�,�, .'� '� . �PPLICATION FO.. �„„„ <br /> p^� � .. CONSTRUCTION <br /> everett PERMIT,. e ' <br /> BUILDINa OEPARTMENT � <br /> 259•8745 TO BE ':OMPLETED IN INK- PLEASE PRINT i <br /> ❑OEMOLITiON ❑COMBINATION ❑ BUILDINO �MECHANICAL ❑ PLUMBINO O SIGN <br /> pWp[p . MMt�DORES9 CRY (ip VNONE <br /> ?r•1�„ a�inr��, ��k P.U.B�h la�l� t.-Jr-•�cr°�� �)f�_W. <br /> MCHIfECIO11DES10NER MI1q�DONFS4 CRY I�P pnONC <br /> OENEMI COMfIUCIOR M�II�ODPESS LIfY ZIP PHONE LICENlE• <br /> MECH�NIC�LCONTMGTOR M�q�DDRE99 CifV 21P PNONE l�C[NSf• <br /> �i�c�reeia S�illSh�e� uir$� P '�0.8a�.1��s� E�!e�c��� `IA�(Y, ��s.� -:,u�� F�'fil�R'JG <br /> PLUMlIHO ON1N�CfOR WIL�UDNE55 CIfV 21P PIIONE . IICENSE• <br /> C1�35Oi Wplk <br /> C`� NEW ❑ ADDITION ❑ AITER�TION ❑ REPAIR ❑ DEMOl1TION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILUINO NELOC�TION <br /> V11WI1t�ON O�WORN�COlT OF M�IERUl9 PW 9 UlOfp <br /> OESGRIlE WORK <br /> ' � � �� �• 1 <br /> use ov euiioi�a <br /> n � 1 HEREBY CERTIFV THAT I HAVF. READ AND EXAMINED THIS AP• <br /> � � • PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECi.ALL <br /> lE0�L0ESC noNorvaove tY�lNOWNlELOWOR111TACNFWRCOPiEB� pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILI BE COMPLETF.D WITH WHETHERSPECIFIED HERE• <br /> �o�_e�ock—ot IN OR NOT.THE GRANTING QF A PERMIT DOES NOT PRESUME TO <br /> OIVE AUTHORITY TO VIOLP.iE OR CANCEL THE PROVISIONS OF' <br /> ANV OTH ER STATE OR LQCAL LAW REGULATINO CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�TUREOFCONTItACTONOf1�UTHORI2EDAOENT D�TE <br /> X � . ,. <br /> PROJECT�DORES! �vP� N 9C vBUSiNE S �r,EN�NO G f�f � l (/ ////a L <br /> O � i <br /> C � <br /> /LUMSINO MECM�NICAL <br /> NO. TYiE OF fIKTUR[ FEE NO. TYPE OF EOUIPMENT fEE <br /> WATER CLOSET TOILED RIR COND.UNITS—H.P.E�. �n�/ <br /> 6ATNTUB REFR�GERATION UNITS—N.P.EA� <br /> UVATORY WASH B�SI BOILERS—H.P.EF. <br /> SHOWER 6�5 FIREO AC.UNITS—TONNRGE ER <br /> NITCHEN SINK�OISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISNW�SHER WALLMEAiERS—B.T.U. M <br /> LAUN�RVTRAY UNITHE�TERS—B.T.U. M <br /> CLOTHES W�SHER EWIPOFATIVE COOLERS <br /> W�TER NEATER CLOTHES ORYERS <br /> URIN�L YENTILATION FAN <br /> DRINKINO FOUNTAIN RANOE HOOD <br /> FIOOR DR�IN AIR HANOLINO UNIT— C.F.M. <br /> J�CUUM BREAKERS STOVE <br /> _ ROOF OR�IN9—RAINLE�DERS METAL FIREPLACE6 CHIMNEV <br /> SINI( SERVICE—B�R,ETC. WOOOSTOVE/FIPEPLACE INSERT <br /> SUlTOTAL SUBTOTAL ! <br /> VERMIT t PERMIT ! <br /> TOTALFEE { TOTALFEE t <br /> THIS PORTION TO BE COMPL�TED BY BUILDING DEPT. PERSONNEL <br /> iRONf3EItl1CK RE�NSETB�CK SIpESET&1CK �L�NCHECKNUMBEN PL�NCHECKlEE <br /> iEE REGEIPf NO <br /> USE 20NE lOT J1REA VACANT SRE <br /> DYES ONO FEE{ VAIU�TION FEE <br /> tYPE Oi CONST. OCCUP�NCY GPOUP NO.OF DWELLINO UNIT9 <br /> BUILDINU f <br /> St2E 01 B100 NOAI STORIE9 M�x.00C.IO�D <br /> PLUMBiNO <br /> MECN�NICAL <br /> FIRE SPRINKIERS REOUIRED ❑VES ❑ NO <br /> OTNEF <br /> PENALTY <br /> 11PPUUIION�CC BY PL�NSC��ECKEDBY 11PPp.FOPI5511�NGEBY ' � <br /> � �OTAL <br /> L, � <br />