Laserfiche WebLink
' � � `,-.PPLICATION FOrc' ���n„ <br /> tMEvayrwe CONSTRUCTION e - - <br /> urt or <br /> everett PERMIT <br /> BUILDING DEPAR7MEN7 TO BE COMPLETED IN INK• PLEASE PRINT <br /> 259-D745 <br /> ❑ DEMOLITION �"COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PIUMBiNG ❑ SIGN <br /> OWi�ER M�IL�DDHE55 CItY 2iP PIIONE <br /> .S{���Z�f�y L S'L� I(b L v14HFrS ��/Ll�� � �.le)f zs�r - �`i3� <br /> •I�GRI�CCIOPOESiGNER M�IL�ODRE55 CIiY 21P PNONE <br /> C �rri° <br /> tilNEA�LCON���C10R M�Il�0�RE55 C�IY 21P P��ONE ��CENSF• <br /> Irq�b9cac�rsr 1t3•� 1/1�����na 9� C�i<n. Frr 9er�� ZS�-7457¢` Nqvs7c.�'2d�v�� <br /> MlGUNIUI CON�PICiQq M�II�ODHESS CIT' LF 1`I UNE L CCNSF <br /> PIUMOMBCONIP�CfOA M�IL�ODHE55 CITY 21P P110NE LICtNSt • <br /> /1!r'/� /jf �iMF3 — '1.9i'LErG <br /> CUSS Oi WONK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ UEMOLItION ❑ WOODSTO�EIFRPl.INSERT BUIL�ING AELOCA710N <br /> V�IU���ONOf WOHItILOSTnf M.11CRI�lSPWSL�BOH1 <br /> l.p (�ip C <br /> msCmec onK <br /> FfRw'(' G�•Tf EHi j�F!'��� �r.r ui pRYt..f« hirvc✓wc.y. <br /> usr.or eun u+c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TIiIS AF• <br /> /1�'y�d(rcf PLIC.4TION AND KNOW THE SAME TO BE TRUEANDCORRECT.AlL <br /> LC6�l0E5CN�P110NO��AOPE0fVI5HOWNBELOWOHATtACNFOURCOPIESI PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> �r� /�y�. OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> io�—e�ocK—or IN OR NOT.THE GRANTING OFA PERAf1T DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OFi CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SION�TUREOFCONiRRCTORORAUiHORIZEOAGENi OAIE I)_/l �� <br /> / <br /> X . 9�riC <br /> •PPLIC�NiS CItY BUSINE55 UCENSE NO <br /> Pf10JEC��OU�E55 <br /> I I U L O /7r5 !-''y <br /> PLUMBINO MECHANICAL ---. <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> Y WATER CLOSET ITOIL[71 AIR CONO.UNITS-H.P.EA. <br /> I BATHTUB REFRIGERA'ION UNITS-H.P. EA. _ _ <br /> V LAVATORV�WpSH BASIW �O DOILEWS-H,P.EA. __ —. <br /> - GAS FIRED AC.UNITS-TONNAGE E0. _ __ <br /> 1 SHOWER <br /> I KITCNEN SINK 8�ISP. FORCED AIR SVSTEMS-B.T.U. M EA. _ <br /> - WALL HEATERS-B.T.�. M __ <br /> DISNWASHER <br /> LAUNORV7RpY UNITMEATERS-B.T.U. M ,_ _ <br /> I CIOiME5WA5HER EVAPORATIVECOOLEHS - <br /> -i� WATER HEATER � CLOTHES DRYERS --_�s� <br /> VENTILATION FAN - <br /> URINAL (rj ' � <br /> DRINKING FOUNTAIN RANGE HOOD — --- - - <br /> AIR HANDLING UNIT- GF.M. _.__ _ <br /> _ FIOOR DRAIN STOVE — - <br /> VACUUM BREAKERS <br /> HOOF DRR�NS-RNNLEADERS METAI FIREPLACE d CHIMNEY ____ __. __ <br /> SINK�SERVICE-BAR.ETC. WOOOSTOVE/FIREPLACE INSERT __ ._._ <br /> � L l __CG'. 3_ <br /> -- V SUBTOT�L s _' - <br /> SUB 70TAL <br /> -- PEHMIT f PERMIT s _— . <br /> TOTALFEE f U 70TALFEE s __-.--- <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL _ <br /> PLAN GNEGK NUMBEH ��������«�<<� <br /> �NUNiSEIB�CK n[AHSEIB�CK SIDESEIB�GN nEGCiPINO <br /> FEE <br /> US!20NE lOf�NEA y�CANi SIfE FEES V�LU�tION FEE <br /> OYES ONO <br /> IYPCOfCON51 OCCUPANCYG�OUP NO.OFOWElLINOUNIIS --- <br /> BUILOING S '�'� 7 � <br /> SitE Of pIOG NO Oi StOPIES M�%.004 LO�D <br /> PLUMBINO YU �� <br /> MECHANIC�L �t <br /> FIRE SPRINKLERS REOUIRED ❑YES O NO OTHER _ <br /> PENA�TY � <br /> •1'PUC�I�ON�CC tiv 1'UNSCNEGNEDBY �PFN FORISSU�NCEBY <br /> TOTAL <br />