Laserfiche WebLink
�PLICATION FO� ��«�„ <br />��^ �� � CONSTRUCTION e � <br />everett PERMIT <br />BUILDINGDEPARTMENT TO BE COMPLETED IN INK• PLEASE PRINT <br />259•8810 ❑ pLUMBING ❑ SION <br />�MECHANICAL <br />� ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Z P pHpNE <br />cin <br />� M�IL �DORE55 n . . �� � 1� � � ��� ', _ <br />� <br />� NEy� ❑ pDDItION <br />��� <br />M.UMSIN6 <br />FEE <br />21P <br />0 <br />�N � qEpq�� ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUIIDING AELOCA��ON <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONSOfLAWSANDORDINANCESGOVERNINGTHISTYPE � <br />UF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED MERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />OR THE P RFORM�NCE OF CO STRUCTION. GCONSTRUCTION <br />SION�TUAE OF CONTF� ��Of OR AUTHORIIEO ��ENT ��tE <br />X � _-!�i�►�t/ �.. L5'-�'S <br />NO <br />MECMANICAL <br />NO. T/PE OR EI <br />NC — MiNOLU UNITS — <br />REFRIGER�nON UNITS — H.P. FA. <br />BOILERS — B.T.U.iM f. <br />0115 FIRED A.C. UNITS — B.T.U. <br />FOACED ��R SVSTEMS —B.T.U. M �� <br />WALLMFJ�TERS—B.T.U. M <br />� �wr ur.�TFRS — 9.T.U. M— <br />��� <br />6 <br />sus <br />I FEE I PECEIPT NU. <br />PLANI:HECR NUMBER <br />WC�NT 5��E --- <br />OYES ONO BUILDING S <br />NO OF DWELLIN�i UNITS <br />PLUMBING <br />M�z OCG ioeD MECMANICAL <br />OTHER <br />STATE BUILD�NG SUHCMARGE <br />$TATEENEPGYSURCHAAGE <br />�VPR FOR ISSU�NGE BY pUBLIC WORKS <br />TOTAL — <br />PROFERTY �INE LOCAiONS ANDNRELATED EASEMENT'8, NO ALL <br />. c� - I�i ',,i,? _ '-� lR -9 n.. d �. <br />'%:;h'i 1 �- - <br />