Laserfiche WebLink
_ .. ..; .. <br /> .,PPLICATION FO�:� ���,�„ <br /> «`�ro`"" CONSTRUCTION e <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8T45 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> M�IL�DLAE53 GITY ZIP Pr10NE <br /> a;�o �a�+�,,.Y wE,�f • 3�� �Z 4 a- <br /> MGNITEGTORDESIONEP M�ILADORESS CI1Y ZIP PNONE <br /> OEHEMLCONiAACTOp MAIL�DDRE55 Cltt 21P PNONE LICENSE• <br /> �i4Yk���� �/• 5ios 2*� A�E w. �✓f,tt�f tftv3 353�t dc(wooIK14 <br /> MEGNANiC�LGONTMCTOq MqI�DDNE53 GTY 21P PNONE LICENSE• <br /> I�/Of SP'n.f.�.�'�'O <br /> RUMBINO GOMTIMCTOii M�IL�DDRE55 GIIY 21P PI10NE LICENSE• <br /> Not yE� � <br /> �«55a�W�� <br /> 'I�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOIITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOC�TION <br /> V�WeT10N OF WORN�C09T OF M�TERIM.3 PLUS UBOR� <br /> �g �i��' <br /> DE9CNISE WORK <br /> GON �'IIG� � <br /> USE OF DU�LOIN6 b I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AR <br /> � N��IZ�' �l1'M��- FFfi ( n�"�C'� PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> LFO�LOEBGRIPiIONOFPROPER ISNOWNBELOW.OnR�TT�CHFWRCOPIES� pqOVISIONSOFLAWSANDORDINANCESGOVEFNINGTHISTYPE <br /> O�f` ��6�,�.� C� OFWORKWILLBECOMPLETEOWITHWHETHERSPECIFIEDHERE• <br /> i �or�e�oe�—ov INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � ANYOTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION <br /> � OR THE PERFORMANCE OF CONSTRUCTION. <br /> � � ���/1 ^ A 516N�iURE OF CONTfl�CT AUTMOP12fD�GENT OATE <br /> `f 4. <br /> PROJECT�U�NE55 �PPLIG�NfSCIt BUSME55 E po� '� � <br /> t l 4 �lIE� G�r�� �'K' � <br /> KUMBINO MECHANICIIL <br /> NO. TYPE OF FIXTUIIE FEE NO. TVPE OF EOUIPMENT FEE <br /> W�TER CLOSET TOILE �� AIR COND. UNITS-N.P.EA. <br /> BATHTUB CIO REFRIGERATION UNITS-H.P.EA <br /> LAVATORV W�SH BASIM BOILERS-M.P.EA. <br /> 3NOWER d0 GAS FIRED AC.UNITS-TONNAGE EA <br /> KITCNEN SINK t 013P. O / FORCEO AIR SYSiEMS-B.T.U. M EA. <br /> � DISMWASHER � WALIHEATEFS-B.T.U. M <br /> LAUNDRVTRAY UNIiHEATEPS-BT.U. M <br /> CLOTHES WhSHER EVAPORA7IVE C��OLERS <br /> WATER HEATER O CLOTMES DRVEHS <br /> URINAL VENTII.ATION FAN V O <br /> DRINKING FOUR�TAIN RANGE MOOD <br /> FLOORORAIN �IRH�NDLINGlIN1T- CF.M. <br /> V�CUUM BRF.AKERS STGYE <br /> ROOF ORAINS-RAINLEADERS MF.!�L FlREPUCE 6 CMIMNEV <br /> SINK SERVICF.-BAR,ETC. WOODSTOVE/FIREPUCE INSERT <br /> 8UB TOTAL � BUBTOTAL • � <br /> �� PERMIT i PERMIT • <br /> TOT11L FEE f TOTAL FEE t <br /> THIS PORTION TO BE COMPLETED BY �UILDING DEPT. PERSONNEL <br /> iNONT SETB�GN PE�R SETB�CK SIDE SETB�CN PI�N CNEC NUM9ER PL�N CHECK FEE <br /> 25� ^� � ^I ��11 �� /^�/7 FEEn�` RE�iP'N�O <br /> � � cJ [y,V'`�� � � <br /> USE20NE ��'O1�OQO ��� y� �Ni51TE <br /> FEE{ V1ILWTION fEE <br /> [��` ES ONO <br /> r1 � <br /> ttPEOiCONST OCCUPeNGYGROUP NO.OF�W[lLINOUNITS <br /> �nl R-3, M I euaoiNo �88`Stln, on b� <br /> SRE OF BLOQ NO.OF 5T PIES M1%.00C.LOAD <br /> •L� w56�kM P'/� �' PLUMBIN6 2a:ou <br /> MELNANICAL 7l <br /> FIRE SPRINKLERB RE�UIRED O YES � NO <br /> OTMER <br /> PENALTY <br /> �FPLIWTION�CC.BY PUNS GHECNED BY �PPH�FOR 1551UNGE BY <br /> TOTAL <br /> M.� . J�.�- �� ' �I�a.sc� <br />