Laserfiche WebLink
i <br /> IMEwrprN^ , .PPLICATION FO�. ���,�„ <br /> °�r°F CONSTRUCTION e <br /> everett PERMIT <br /> � TO BE COMPLETED ItJ BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAIL�DORESS Cltt 2iP PHONE <br /> 11'lJkl�� �--�livl - (�'oV����� �niiat�ci�y �. is� R 2'i]� �.iiri? ��. 9k�.n3 _ 3�3-�aLi <br /> �RGHITEGTOR�ESIGNEfl M�Il�00BES5 CIiV IIP PIIDN[ <br /> -�f��+�lC <br /> GENERA�CONT/P��CTOB MMLADpRESS CITY TIP PIIONE LIGENSE• <br /> MEGH�NICAL C011TR�CTOq M�IL�OOfiE55 C:tt IIP PIIONE ULENSE• <br /> PLU6,�INOCONtfl�CTOR MAII�ODRESS f.ltt IiP PIIONC LICENSE• <br /> G�U.-�/53OF WORR <br /> L7 NEW ❑ AODITION ❑ ALTERATION CI REPAIR ❑ DEMOLIT�ON ❑ WOODSTOVEi�RPL.INSERT ❑ Bl11LDING RELOCATION <br /> VAl ION OF WORK�CAST OF M�TERIALS PLI15 L�BOR� <br /> CXJ <br /> � <br /> OESCRIBE .ORN <br /> 'J��- X30 � ilvGl_l: JTOR � �) 2YL .=1 �- ` <br /> USE OF BUILOINO <br /> C't A� /�� G K I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT.ALL <br /> LEO�LDE9CNIPTIONOFPPOPERTY�SHOWN 9ELOWORATT� IIFOIIRCOPiESI pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> "j7:Ha.T %I - t'��K S 2�`��`�? � ���^��t�`�` OF WORK 1hYLL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br /> LO�'��OF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PqESUME TO <br /> GIVE AUTHOHITY TO VIOLATE OR CANCEL T 'E PROVISIONS OK �� <br /> CGO 11 G - ��.'..A1 �'�GR�' GC I:EC�R cR1JYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION � <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> VO<<AII, �, �I�bE ��• (��7 � TD�t C�' SND. �.;� . SiGNATUREOFCONTBACTORORAUTMORIZEDAGENT ORTE <br /> St/-11 C o F r/��4 l� . x LGLE�-�.:w �G�-, -„" r' , <br /> PR0.IECT ADDflE55 �VpL�CANTS GI7Y BUSINESS IICENSE NO ���r� <br /> 7sa9 r�'A, tii � r- R. �v �Kk-17' . <br /> PLUMBINO � - MECHANICAL <br /> NO TYPE OF FIXTLRE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) AIR COND. UNITS—N.P.EA. <br /> BATHTUD REFRIGFRATION UNITS—H.P.EA. <br /> V':nfON'�WASH BASIN� BOILERS—HP. EA. <br /> SHON'ER GAS FIRED A C.UNITS—iONNAGE EA <br /> KITCHEN S�eK 6 DISfl FORCE�AIR SYSTEMS—d.T.U. M EA. <br /> OISHWAF.IER WALL IIEATERS—B.T.LL M <br /> LAUNDRV TflAV �1NIT HEATERS—B.T.U. M <br /> CLOTHES WASIIER EVAPOflATIVE COOLERS <br /> WATEH HEATER CLOTMES DRVERS <br /> UHINAL VENTILATION FAN <br /> DRINKINO FOUNTAIN (iANGE HOOD <br /> PLOORORAIY AIRNANDLWCUNIT— C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF URAINS—RAINLEADERS METAL FIqEPLACE 8 CHIMNEV <br /> SINK 9EFVICE—BAR,ETC. WOODSTOVE/FIREPLACE INSERT <br /> 8UBTOTAL SUBTOTAL S <br /> PEpMIT S PERMIT f � <br /> _ TOTALFEE _ f _ TOTALFEE i� <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONTSETBACK qEFNSETBACK SIOESEiBACK PlANp1EGKNlIMOER � PL�NCIIECNi[E <br /> Z� ' Zo � [ � _� � FEE��O RELEIP�Nf(]��� <br /> USE20NE LOTARE� c5 ` <br /> �(i VAL�N tE FEES V11LUI1TION FEE <br /> ^ ' ( �t`�iyCC' S��.hi. ❑YE NO <br /> NPEOFCONST. OCCOP�NCYGROUP NOOFOWEllIN6ONIT5 <br /> SI:E O�O. N0.OF�FI� IAA%.OCC� ��� �D � <br /> BUILOING S <br /> �J2O Si F � I�/�. PLUM�ING <br /> MECIIANICAL � <br /> FIRE SPRINI'LERS REOLIIRED ❑VES O <br /> OTHER <br /> PENALTY <br /> �PPUC�TION�CG.BY PLANSCIIECNEDOV dPPRFORI55UANCEBY , <br /> ' ` ' n . � ^ TOTAL — . <br /> �?;� ��G� �� <br /> �:• <br />