Laserfiche WebLink
�� <br />�;�;:a <br />�i�'PLICATION FC►h=>> <br />'".Ew,°'"" CONSTRUCTION <br />tin or <br />everett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259•8810 <br />n ncun� �r�nN <br />❑ COMBINATION �P9UILDING O MECHANICAL <br />d <br />❑ PLUMBING <br />❑ SIGN <br />._ _ ...... — nn OHnN[ 16ENSE • <br />/ <br />MEGN�NIGLCON1RACiOq MnIL�00RE55 CIiY IIP PIIONE UCCNSE• <br />VWMBINGLONIR�LiO� M�ILADDRESS CI1Y IIV P��ONE lIL6N5E• <br />� <br />:U55Oi WORK <br />❑ NEW ❑ AODITION ❑ ALTERATION REPAIR ❑ DEMOLITION ❑ WOODSTOVElFRPL.INSERT ❑ BUILDING RELOCA710N <br />��LLMTIONOFWOPK�GOSIO�MAIERI�L5VW5LABOPI � <br />wr_.—e�oc�—or_ <br />n <br />PLUMBING � <br />( NO. TYPE Oi <br />W�TER CLOSET IT <br />jI BATHTUB <br />i UVATORVIW�SN <br />KITCHEN SINK 6 DISP. <br />OISHW�SMER <br />UUNOFY TRAY <br />CLOTHES WASHFR <br />UAINAI <br />OFAIN <br />' ORAINS — RaINI <br />�SERVICE — BAR. <br />SEIBSC1t <br />OR <br />SUeTOTAL <br />OERMIT <br />TOTALfEE <br />OF <br />sr <br />SIDE <br />VAG�NLSRL <br />OYES ONO <br />UNIfS <br />or <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAMETO BETRUE AND CORRECT. ALL <br />PROVISIONSOF LAWSAND OROINANCESGOVERNING 7HISTYPE <br />OF WOFK WILL BE COMPLETED WITH WHETHEF SPECIFIEO HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHCRITY TO V�OLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONieRCiOR O� AU�IIORIZEO AGENT 04IE <br />CIIV <br />MECHANICAL <br />NO <br />TYPE OF EOUIPMEnT <br />A/C — A/MNOLO UNITS — M P. <br />REFRIGERATION UNITS — M P. EA. <br />BOILERS — B.T.U/H P. <br />GAS FIRED AA. UNITS — B.T.U. <br />FOHCED AIR SYSTEMS — B.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNIT HEATERS — B.T U. M <br />EVAPORr1TIVE COOLERS <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGENO00 <br />WATER MEATER : <br />WOOCS70VE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPUICEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN _ <br />SU! T0T11L <br />PERM�T <br />TOTAIFEE <br />PIAN CMECN NUMBER I FEE <br />BUIID�NG S <br />PlUM01NG <br />MECHANICAI <br />OTHER <br />STATE BUILGING SURCHARGE <br />STATEENERGYSURCH�AGE <br />PUBLIC WORKS <br />TOTAI <br />RECEIPT NO. <br />PROPERN OWNERS ARE RESPONSIBLE FOR DETERMININCa ALl <br />PROPERN LINE LOCATIONS AND RELAIED EASEMENTS. <br />