Laserfiche WebLink
� <br />AP�LICATION FOR eV�,�„ <br />'".E"ro'"" CONSTRUCTION e <br />cirr or <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ CUMBINATION �%BUILDING �MECHANICAL �LUMBING ❑ S�GN <br />�,yH�q M�ILAODRLSS GN 21P PNONE <br />�7F1�aCo�vrrrCo � �79oi /3orrr� w�YsE �nf�. 5�ir��oS 98viz 9Si-7�8¢ <br />ANCNrtlC10RUF5iGN[H M�ILADOR[55 ` CITV Ji PNONL <br />✓�✓ <br />GENERPI LONiRAC10R MMl ApORE55 C�*Y Z6' �r�0'IC uCENSE • <br />�__ . <br />Grv <br />PIIONF IICI <br />�'NEWV O �D�ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOUTION ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDING RELOCATION <br />VALUAiiONO�tYORn�COSiOF�AAfCHIALSPWSLPBORi � J^�, <br />���/J nrin°� iiOU.`�i. _�J� <br />D[SCRIO[ WORN <br />LCC.AL OES( <br />ioi� <br />OR P11AC11 <br />J <br />vao�er,t <br />PLUMBING <br />WATER CLOSET �TOILET� <br />BATHTUB aL 'r��j <br />LAVATORYIWASH BASINI <br />SHOwER <br />KITCNEN SINK d DIS?. <br />DISHWASHER <br />LAUNDRVTNAV <br />CLDTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />rwr �n..�iw — <br />SINK �SERVICE — DAN. ETC � <br />SUB TOTAL f <br />PERMI7 f <br />TOTAI FEE f <br />��+UNiSEt04C�.� � AEARSEI <br />�40 + - /E <br />III:I 1CN[ LOi AREA <br />�.5 S <br />1�t�L O� C0Y51 OCNPA� <br />yu p}_e� INO OF <br />Mirf*� <br />,,��� <br />I 40 ✓nn�i�.l tlPFCrLI��i'. t� <br />7 �j-�(o CaRI-• � <br />FIRE SPRINKL[RS R[OUIRED <br />�� Vi i�>LJ4 aCC !i� PLf.NS <br />�1 <br />3ACK � � SIDI SEtBAGN <br />;, � zq � <br />Z ` �VyAc�CANT SITC <br />l /% / ��'— /�'ES ;�40 <br />�Y�qOU�' NOOFDWFLLIti <br />� � 1 I <br />OPiES MAX OCL .OAD <br />2 4 <br />/`� <br />I HER[BY CERTIFY THAT I HAVE READ AND EKAMINED THIS AP� <br />PLICPTION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BECOMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTFUCTION. . <br />SIGN OF GONIfiACTG�'.OR AUTf10RIZED AG[NT DATE <br />/I . � � / / <br />A{+�IUNiS GIIY pU51NE$S UC VWy NO <br />O / 94 / o Ts5c�1] <br />MECHANICAI <br />TYPE OF E�UIPMENT <br />AiC — A/MNDLG UNITS — HP. <br />REFRIGERATION UNITS — HP. EA. <br />BOILEFS — B.T U.�H P. <br />GAS FIRED A C. UNITS — B T.U. <br />FORCED AIP SYSTEMS — B T.U. <br />WALL MEATERS — B.T.U. <br />UNIT HEATERS — O.T.U. <br />EVAPORATIVE COOLEFS <br />CLOTHESORYERS <br />VENTIIATION FAN <br />RANGEHOOD <br />WATER MEATER <br />WOODSTOVE <br />MEfAI FIREPLACE 8 CHIMNE�' <br />FIREPLACEINSERT <br />HEAT PUMP <br />GA$ PIPING . <br />EaMAUSTFAN <br />VLANCM CKNUMBER <br />� � ?S �5$ � 021 C� � <br />ORi55UANLF <br />/ii^.� <br />M <br />M <br />SUBTOTAL <br />PEqMIT <br />TOTAIFEE <br />FEE <br />�sa <br />BUILDING $ <br />PLUMBING <br />MECHANICAL <br />orriea <br />STATE BUILOING SURCHARGE <br />S7ATEENERGYSURCHARGE <br />PUBLIG WORKS <br />TOTAI <br />FEE <br />RECEI.PTI NO. <br />� 1 ✓I <br />PROPE.RTV OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCAi IONS AND RELATED EASEMENTS. <br />0 <br />