Laserfiche WebLink
�1PPLICATION FG':� everen <br />'".E"'°'"° CONSTRUCTION � <br />cin oF <br />everett PE RM IT <br />TO BE COMPLETED IN BLACK INK — PLEASE PRINT <br />BUILDING DEPT. <br />259•8745 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />cirr <br />PLUMBIN6CONiR�CTOR M�ILA��NE55 CILY ZiP P��ON[ UCCNSE• <br />CI.�SS OF W� <br />❑ NEW <br />USE <br />�oTL <br />PROJECi <br />ADDIT�ON ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ W'JODSTOVE/FRPL.INSERT � BUILDING RELOCATION <br />iINK 6 <br />1ER <br />TRAV <br />1 HEREBY C[R71FY THAT I HAVE READ AND [RAMINED THIS AP- <br />PIICATION ANO KNO�V THE SAME i0 BE iRUE AND CORRECT. AlL <br />T�GMiOURGOPIESI PROVISIONSOFL�WSANDORDINANCESGOVERNING?HISTYPE <br />��T � OF WORK WILL �E COMPIETED WITIi WHETIIER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF p PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLAT[ OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATU OF CONiRACTOR OR AUTNOR�ZEO AGENT D�1E � <br />� ..A . X ,Na.._ � C`�� �� � �-,�-d <br />R[FliIGERATION UNITS—NP. EA. <br />BOILERS-1/ fl EA. <br />GAS FIRCD � C UNITS—iONIJAGE <br />fORCED AIR SYST[Id5—B T U. M <br />WAI I HFATFRS—AS.U. M <br />AIR <br />M <br />PENMIT 5 ____..._.—__—______ _. <br />TOTALFEE f _ _ TOTALFEE ____. _$._ <br />TH�S PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />pEAqSETOACN SIDESEIORCK PIAIICHECNNUMBCN PLAHCHCCK <br />� vice ]3 necgi <br />2,mr�T 2Or� �f'y ��( ��(30� 3G, — � � <br />USE20HE LOTARE� IVAC�NTSRE FEES V�LURTIOH <br />1YPE O� N5� <br />�� � <br />512E OF B103 <br />3,y � . s, f. <br />M <br />OF STOHiES <br />1 <br />PLANS CNECNED BY <br />}�-UJ7"Y1 � <br />pYES ORO <br />NO. OF O W ELUNG <br />1,1A <br />L•� <br />ur <br />BUILOING <br />PLUMBING <br />MECIUNICAL <br />OiNEF <br />PENALiY <br />TOTAI <br />: <br />FEE <br />►1�� <br />u <br />♦ <br />z■ <br />