Laserfiche WebLink
�T , <br /> I. <br /> ,,PPLICATION FO�� ��«<„ � <br /> '".E"'°`"" CONSTRUCTION e <br /> un oF <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK�NK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING � SIGN <br /> � OWHEP MAILADORE55 GIiY 21P PNONE <br /> / a.....� <br /> l '��� . . `�L.TI`:�_L�1t. a'-i�. ) ' /.:i'+!s �� L�'Y <br /> � ANCNIIEGTOR�ESIGNEN M�ILAOORESS Citt 21P PNONE <br /> • <br /> ��T. Z�p PNONE �� ��GENSE• <br /> GENER�L CONTIIAGTOR MAIL ADDNE55 / l /✓i`��S� <br /> �' r !•/i� • �i' !� � � -� ^�iG'��"T %'SZ'OJ�%. /!o/ I?`... <br /> ,v/J-� � � ��ry Z�p PHONE LICENSE <br />� MECN�NIC�LLONTPACTOq MML�D�RE55 ` <br /> ��n. Z�p PNONE LICENSE• <br /> PLUMBINGGONiR�GiOR MMLADDNE55 <br /> w <br /> �L�55 0(wOAK <br /> NEW ❑ ApDITION ❑ ALtERAiION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT BUILDING RELOCATION <br /> VAW�110N01'WaliK�C05T01 MAILRULSPLl1SLR00R� <br /> i 7����-=Y:. <br /> o.^�t �/' o <br />' DESGRIBE WO�K / � I c� � <br /> ,./ + ^? i=• '•� ''..�..�'./°...u�i-� �>/(../: �i �Ji/Y't2_ /t=� . , �/� i.-� •. <br /> ,.y��� Cil'.: <br /> USEOFBUILDING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• Z <br /> �,� .�1.jj PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL � <br /> LEWLOESCRIP710NOFPNOFENtVISNOWNBCLOWOR�T1�CNi0URGOPiE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OFWORKWIlLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- m <br /> LOT_oi��K__oF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> ANYO HTER STIATE OR OCAL L�AW REGULA ING CONSTR�UCTION <br />� OR THE PERFORMANCE OF CONSTRUCTION. / � '� <br /> • SIGNATUFE OF LONTRACTOR OR AUTNORIZEb AGENT DATE I Z�/�I�/&� "" � <br /> fn 2 <br /> m <br /> 1 X � � <br /> co <br /> " .,� ����= �� v m o <br /> �r� i' � • � <br /> �PPLICANTS QTY B1151NE 55 LICEIISE NO .--� C <br /> PROJEGT�DORE55 � -��` <br /> � m <br /> -��7/ l :� ��: ,' ,/.= !'"1 /'�-✓i..�..rl. 2 -Z-I <br /> MECHANICRL m <br />� PL::MBING FEE NO. TYPEOFEOUIPMENT FEE � <br /> NO. TVPE OF F:%TURE "� Z <br /> WATER CLOSET�TOILEn A��COND. UNITS-��.P.EA. <br /> REFRIG[RATION UNITS-H.P.EA r = <br /> .. .. <br /> BATMTUB BO'LERS-N P.EA. "'� N <br /> LAVATORVIWASH BASIN� '� <br /> GAS PIRED AG UNITS-TONNAGE EA T <br />' S110\VER FORCEDA�F75YSiEA1S-B.T.U. MGA. <br /> KITCHEN SINK 8 DISP. T n <br /> WALLHEATERS-B��.U. b1 --�(tl <br /> D�SMWPSNER UNITMEATERS-B1.U. M = <br /> m � <br /> IAUNORV iRAV �- �/1 <br /> EVnPORATIVE COOLERS p <br /> CLOIMCS�N4SH[R CLOTHES DRYERS O r <br /> WATEF IiEATER VENTILATION FAN C N <br /> N <br /> UAINAL RANGE HOOD <br /> DRINNING FOUNVJN � r <br /> AIR MANDLING UNR- C F.M. <br /> fLOORDRAIN $iOVE � m . <br /> VACUUM BREAKERS n <br /> ROOF DRAINS-RA�NLEtiDERS <br /> METAL FIflFPLACE6 CHIMNEV A I <br /> SINK SERVIC[-BPR.ETC. \YOO�STOVE/FIREPLACEINSERT = i <br /> - a <br /> z <br /> � <br /> x <br /> _ � I <br /> _ SUB TOTAL s Z ' <br /> SUB TOTAL S O <br /> PERMIT S PERMIT � <br /> TOTALFEE s <br /> TOTALFEE S n <br /> m <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PLAN CIIFCK NUMBER GUN CNEGN iEE <br /> fRONt5ET0ACN NEARS[TBAGR SIDESItBACN qELEIPTNO. <br /> FEE � <br />♦ <br /> USE ZONE LOi AREA yp�pNT SItE FEES VALUATION fEE _ <br /> ❑Y[5 ONO <br /> Ttl'EOfCONSi OCLUPANGYGROUP NOOFDWELLINGUNIiS ` <br /> DUILDING : <br /> SIZE OF BI�G NO OF S10RIC5 M�%.OCC.LO�D <br /> PLUMBING <br /> MECHANILAL <br /> ; <br /> FIRE SPRINKLERS REOUIRED ❑ �ES ❑ NO On�ER <br /> PEIULTY <br /> � APPLICATION ACG OY P�/NSCNELkEO BY RPPR.fOR ISSIIANCE BV <br /> ��I��� TOTAL <br /> � G �, <br /> ��� y , U�- ►z����- <br /> r . <br />