Laserfiche WebLink
,�,E„ro�,� . .PPLICATION FO.. ' ,��,�„ <br /> ��TM�F CONSTRUCTION e <br /> everett PERMIT <br /> BUILDING OEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑COMBINATION ❑ BUILDING }�MECHANICAL ❑ PLUMBING ❑ SION <br /> OWNEuR' M�ILADORE59 (r CItY .� ZIP FNONE <br /> }�u�a�� , ���.ra X— /�io �71,[tZ���_ L�eE-f4� -�F'i�. iS�u�_ .7_S'�-536-2_ _ <br /> •pCHIfECTON 15 NER M�I�1100RE59 CItY 21P PNONE <br /> l <br /> GENER�LCONTH�CTOq ' /) M�IL�DDRESS GIIv ZIP PHONE LICENSE• <br /> ��-p-��r-Hs47,T-7�'�ri . /7�"T . �r i� ' 'C ' . V ' .it I�'r// F A/Q /f 3 L? I i <br /> MEC�UNi �LCONiP�GTOq M�IL�DDNE55 � CITY � 21P P��ONE LiCENSE• <br /> / / <br /> (�i//f v�/�-r�.c�-( ��.s iiaa � t/;��Fulav y�s Eui�.'.�/!t A �iJ'>�Y 3ss���.,n /-,dLL F ti B is.��,ii <br /> VLUMBiN�iCONiR1CfOR M�II�ODNESS �—� CIIv 21P PIIONE IICENSE• <br /> CU53OF WOqN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOCDSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�W�TION�O/F WORN�GOST Oi A'�TERI�LS PW9 L�BORI <br /> /Q �Y•o O <br /> OESCPIBE WOPK <br /> �d[,t�' � �u 7.�ti1 ./�T!/. <br /> useoram�oiNn � I HEREBY CERtIFY THAT I HAVE FEAD AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAMETO BE TRUEANDCORRECT.ALL <br /> LEO�lOESCRIPTIONOFPFOPERTY�SHOWNBELOWOR�TTIIGNFOURGOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WORK WILL BE COMPLETED WITH WNETHER SPECIFIED HERE- <br /> �or_e�ocK—or_ IN OR NOT.THE GRANTING OF A PERMITDOES NOT PRESUME TO <br /> GIVE AUTHGRITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. I <br /> SIONATUREOFCON�RACTORORAUTHORIZED�GENi DATE <br /> �/ ,� n I <br /> ' .CG.L. 'C.1(i� ��'0 tj�� � <br /> Pi1pJECTApDPE35 APP4L�NiSCITYBU51 LICENSENO. <br /> a`�� N/ C � _ �I�I <br /> PLUMBINO MECHRN�CAL <br /> NO. tYPE OF FIXTUPE FEE NO. T'PE OF EqU1VMENT FEE <br /> WATER CLOSET(TOILEi) AIR COND.UNIiS—H.P.&1. <br /> B�iHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAV�TORYIWASH BASINI BOILERS—M.P.EA. <br /> SHOWER OAS FIRED 0.G UNITS-TONNAOE EA <br /> NITCHEN SINKB DISP. FORCED AIR SYS7EMS-B.7.U. M EA. <br /> DISHWASHER WALLHEATERS-B.T.U. M <br /> L�UNOHV TRAV UNIT HEATERS-B.7.U. M I <br /> CLOTNES WASNER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS � <br /> URINAL VENTILATION FAN <br /> DRINKING fOl1N7AIN RANGE HO00 <br /> FIOOR ORAIN AIR HANOLING UNIT- G.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOFORAINS-PAINLEADER9 METALFIREPL�CEBCHIMNEV — I <br /> SINN SERYICE-BAR,ETC. WOOOSTOVE/FIREPLACE INSERT <br /> SUBTOTAL SUBTOTAL f i <br /> PERMI7 t PERMIT f <br /> TOTALFEE t TOTAIFEE ! <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FNONf5E1B�CN 11E�RSEiB�CK SIOESEiBACK PUNGHECNNUMOER PIANCHEGNiEE � <br /> IEE RECEIM NO �� <br /> USE 20NE LOT�NEA VAC�HT SITE I <br /> OYES ONO FEES VALUATION FEE <br /> TYPEO�CONST. OCCUPANCYGPOUP NO.OFOWEILINUUNiI$ <br /> BUILDINO S <br /> S12E OF B100. NOAF S10RIE9 M�;OCG 10�D <br /> PLUMBING <br /> MECHANICAL <br /> FIRE SPRINKLERS REOUIRED ❑YES O NO <br /> otHen <br /> PENALTY <br /> ��PUC�f10N�CC.BY PUNSCNECNEOBY �PPR.FORISSU�HCEBY - <br /> TOTAL <br />