Laserfiche WebLink
,..«, <br />�PPLICATION FOk� <br />rE« "'" CONSTRUCTION <br />everett PE R�I IT <br />BUILUIN(3 DEPARTMENT <br />269•8810 TO BE COMPLETED IN INK - PLEASE PRINT <br />� DEMOLITION ❑ COMBINATION ,f�'BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />�O SION <br />OENEMIGONTRl1GTON MML�DORE35 Cin' iiP oNONE 4CENSE• <br />S.,P�.� l�o. a sso�. �.�'�a,K. �d 1.�,.�t' /ti& �x� .�s,�-cr� ss��w ix3 <br />'� MECM�NIC�L CONTN�CTOq M�IL ADORE53 CIT' LIF PNOHE IIGENSE • <br />►LUMBINOGONTR�CTOR MML�DpRESS C�fY 21P PIIONE 4CENSE� <br />NEW ❑ ADDITION ❑ ALTERRTION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCAiION <br />TiON OF WOFN IC09T OF M�TERI�LS GlUS LIIBORI <br />�� � <br />77, .�9Z =' _ <br />G� <br />M.UMSIN6 <br />NO. TY/E OF fl1 <br />N�I1T!'R CLOSET �TOIU <br />9ATM7UB <br />' UVATORV IWASH 8�: <br />SMOWER <br />� KITCHEN 91NK 6 DISP. <br />' OISHWI19HEii <br />� ' LAl1NDRV TUV <br />0 <br />CLO7NE3 WASHER <br />URINIIL <br />' DPINKIN6 FOUNTAIN <br />FLppR DRI11N ' <br />BACKFLOW PREVENT <br />ROOF DRAIHS — RAI� <br />SiNN ISERVICE — BAF <br />FPON7lETB�CK <br />�c <br />er <br />0 <br />roun <br />25• 7 i � <br />aE� v�r,�Nt sirE <br />/� z �Gr ES ONO <br />IP NGYGPOUP NOAFOWELLINO <br />1P-3 � <br />�f STORIE9 M�%.00C. LOAD <br />- f3y� N.4 <br />�,W�, I /.�. <br />•PPq FOHISSU�N <br />' �.K/ <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP• <br />PLICATiON AND KNOW TH E SAM E TO BE TRUE AND CORREC?. ALL <br />PROVISIONS OF LAWSAND ORDINANCESOOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTIN60FA PERMITDOES tJOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL' TME PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW RE6ULATINGCONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. ''� ;�% <br />SIONATURE OF CONTR�CTOR OR �UTHORIZEO A�ENT �ATE <br />- �a.•� ��_ 3-/b •dX <br />MECHANICAL <br />Ho, rrve or �ouiv�Nr <br />AIC — NMNDlO UNITS — M.P. <br />REFRIGERIITION UNIT$ — M.P. EA. <br />BOILERS — B.T.U.M.P. <br />OAS FIREO A.C. UNITS — B.T.U. <br />fORCED AIR SVSTEM9 — B.T.U. M EA. <br />,•�LLMEATERS—B.T.U. ' M <br />uNITMFATER3—B.T.U. M <br />VENTIIATION FAN <br />R�NGENOOD <br />WATERMEATER <br />wOOD STOVE <br />METIIL FIREPUCE 8 CMIMNEY <br />FIRF.PUCE INSEHT <br />HEATPUMP <br />OA9 PIPINU <br />E%M�USTFAN <br />NUMBER <br />TOTAL R[ w /( 7 <br />���� <br />IFEE RECEIPT NO. <br />3�� 43 95s�s/S <br />BUILDING 5 "j � Z � <br />PLUMBING <br />MECHANICAL / <br />OiMER ��p,U^ � <br />STATE BUILOIN6 SURCHARGE <br />STATEENERG�SURCHARGE —�' <br />PUBLIC WORKS 2 <br />TOTAI � <br />PROPERiY OW NERS ARE RESPONSIBLE FOR DETERMININO ALL <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />