Laserfiche WebLink
`�:y4PPLICATION FG� <br /> p�"'�""' CONSTRUCTION e <br /> everett PERMIT <br /> BUILOING DEPARTMENT <br /> 259•87a5 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑DEMOLITION ❑COMBINATION ❑ BUILDINO O MECHANICAL �PLUMBINQ O 81ON <br /> pyypEq MML�DDRE59 CItY IIP MONE <br /> f�.�JCs &,xcl'caL�, ���+_ 1kc�;ft q��;'„o. F',�rr�tt.WA 4'8•2e� <br /> VIGNITEGTOROESIONEP M�iL�ODRE99 CIIY IIP PHONE <br /> OENEP�L CONfP�CTOR M�It�ODRE53 Cltt 21P PMONE L1GENlE• <br /> MECM�NIG�I�ITMGTOq/�/A{f�� M�// " �+�. �vY,►��`G�_ 94,U1 ����i P('� LICEMI�'� <br /> Y� <br /> UMOINOGONiMCtOR MML�DORES9 Cltt SIP N10NE LICENbE• <br /> CL�!!Of w0111t <br /> Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br /> V�IU�fIONOFYARN��y STO�M�tERUL9VWSl�BOPo � <br /> G'aS I'"�DiriO � s�e-� (�ro���N <br /> oexn�ee wonK <br /> useorsuaoira I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED TN19 AF <br /> PLICATION AND KNOW TH E SAME TO BE TRUE AND CORRECT.ALL <br /> LEO�LDESGNIPTIONOiPROPEPTY�3HOW1lBELOWOR�TT�CHFOURCOPIES� PqOVI810NSOFLAW3ANDORDINANCE3QOVERNINOTHI3TYPE <br /> OF WORK WILL BECOMPLETED WITH WHETHERSPECIFIED HERE• <br /> �or_e�ocK—or �N OR NOT.THE ORANTINO OF A PERMIT DOES NOT PRESUME TO <br /> OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF' <br /> ANY OTMER STATE OR LOCAL LAW REQULATIN4 CON9TRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. n! <br /> SIONATIIPE OF CONTRACTOP OR AUTNORI2ED AOENT O�TE ���Sp <br /> . A � <br /> PRQIECT�ODRESS APPLICANTBqTYlUSINEBSLIC ENO. <br /> 1 <br /> PLUMSINO MECNIINICAL <br /> NO. TYPE Oi FIXTUIIE FEE NO. TYP[OF EOUIPMENT fEE <br /> W�TER CLOSET 1011.E �IR COND.UNITS-H.P.EA <br /> BIITHTUB REFRI�ER�TION UNITS-H.P.EA <br /> L�VATORY'WA9H B�SIN� BOILERS-H.P.Ell <br /> SHOWER OA9 FIRED AG UNITS-TONN�OE EA <br /> KITCMEN SiNK i DISP. FORCED AIR 9Y9TEM3-B.T.U. M Ell <br /> DISNWASHER W�LLNEIITER9-B.T.U. M <br /> L�UNORViR�V UNITHEATERS-B.T.U. M <br /> CLOTNES W�9HEP EV�POMTIVE COOLER9 <br /> WAiER HE�TER CLOTHES DRVERS <br /> URIN�L VENTIUITION FAN <br /> DRINKINO FOUNTAIN RANGE HOOD <br /> FIOOR ORAIN AIR MANDLINO UHIT- C.F.M. <br /> V�CUUM BRE�KERS 9TOVE <br /> ROOF OMIN9-R�INLEADERS METAL FIREPL�CE 8 CHIMNEV <br /> SINK SERVICE-BAR,ETC. WOODSTOVE/FIREPLACE INSERT <br /> BUBTOTAL BUSTOTAI • <br /> PERMIT / PEIIMIT 1 <br /> TOT11L fEE � TOTAL FEE t <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> fNONT SE78�CK AE�R SETB�CK SIDE SEiB�CN PLAN CNECN NUMBER PL�N CHECI(iEE <br /> iEE RECEIPT N0. <br /> USE20NE LOTARE� WC�NTSITE <br /> F![t V�LUIITION F[! <br /> OYES ONO <br /> T'PEOfCONST. OCGUP�NCYGRDUP NO.OfOWELLINOIINlf3 <br /> BUILOIN4 f <br /> SRE OF BLDQ NU.Oi S10RIE9 M�K OC4 LO�O <br /> PLUMBINO <br /> MECMANICAL <br /> FIRE SPRINKLERS REOUIRED ❑YES ❑ NO <br /> OTNER <br /> FENALTV <br /> •PPLIC�t10N�CG.BY PL�NSCHEGREOBY �PPR.FOR195U�NGEBY <br /> TOT�L <br />