Laserfiche WebLink
I� <br />rn. ewrorwn <br />wn o� <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />'`�' PLICATION FOR� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />�',/' � <br />YVLA' �l � <br />!Y!r!M <br />e <br />❑ DEMOLITION ❑ COMBINATION �BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEN M�IIADORE55 ' LITY . 'ZIP_ ^MONE ^_— <br />' <br />Gltv <br />PNONE <br />LICENSE � <br />�JLL �1 <br />LICENSE • <br />PWMB�NGGONiRACfOR MAIL��ORE55 Cltt 2iP PIIONE IICGNSE• <br />:U53OF WONK <br />❑ NE�N ❑ A�DITION � ALTEPATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUIL�ING RELOCAiION <br />� <br />•OOPE9S <br />VLUMBIN6 <br />OR <br />WATEP ClOSET �TO�'.ET) <br />BATHTUB <br />UVATORV IWASN BASIN� <br />SMOWEN <br />ICITCMEN SINK A OISP. <br />W�SHER <br />DRINKINO FOU <br />FLOOM DRAIN ' <br />— R�INLEADERS <br />. — BAR. ETCJ <br />SUSTOTAL <br />PlPMIT <br />fRONiSEiB�Ck NEAR <br />... _'��...._. _' __ <br />'/�% B - Z <br />7� / NO OF STORIES <br />Y"�'l' .S �' � <br />�NPIILAiIONRCC 6V <br />1•`�� • <br />SIDE SETB�CK <br />V�C�NT, TE <br />❑vE5 �!O <br />NOAF DWF.LLINO <br />6- <br />M�M OLG. LOAO <br />3S <br />APPR FONISSU�N <br />/ �/ <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE 5AMET0 BETRUEANDCORRECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OFA PEriMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNRTURE OF CONiRRCTOR OA RUTNORIZEU AGENT [IATE �� 'i� .� <br />X / � �,It'✓� � <br />MECHANICAL <br />AiC — MMNOLG UNITS — H.P. <br />NEFRIGERATION UNITS — M.P. EA. <br />BPILERS — B.T.UIF7P. <br />GRS FIRED A.C. UNITS — B.T.U. <br />FORCED AIR SVSTEMS — B.T.U. <br />WALL HEATEFS — B.T.U. <br />UNIT HEIITERS — B.T.U. <br />EVAPOAATIVE COOLERS <br />FAN <br />STOVE <br />FIREPLACE 6 CHIMNE� <br />ACEINSERT <br />GAS PIPI� <br />EXHnUST <br />M EA. <br />M <br />M <br />SUSTOTAL <br />P[RMIT <br />TOTALFE[ <br />Pl� M C� -I �E'3 � FE��O� <br />FEES VALUATION <br />BUILDING � <br />PLUMBING <br />MECMANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WOFKS <br />TOTAI <br />RECEIPT NO. <br />PROPF.RiYOWNERS ARE R_SPONSIBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCATION6� hNU RELATED EASEMENTS. <br />