Laserfiche WebLink
� � � �PLICATION FO� <br /> '"'`"""� CONSTRUCTION !�e <br /> � GT'OF <br /> �, everett PERMiT <br /> BUILDING DEPARTMENT <br /> 259•87a5 TO BE COMPLETED IN INK - PLEASE PRINT <br /> ' ❑ DEMOLITION ❑ COMBINATION 47"BUIIDING ❑ MECHANICAL ❑ PLUMBING ❑ SION <br /> OWNER M�it�DDRESS GITY ZIV PNONE <br /> :; DQv�� N �lolfltlS�N q6�� �!� Pi NE' EC/ -�"TT 9Pz6s 3�Y�qq <br /> ARCMrtEGi0A0E510NER MML�OORESS Citt IiP FMONE <br /> ' C�4 M� -- <br /> i OENEP�L GONiR�G R M�II ADDIiECS CItV L� OMONE IICENSE• <br /> MECNAHIGI GONIR�GIOfl M�IL��ORE55 CIIY IIP PNONE UCENSE� <br /> KUMlMOWNiR�CiOR ��IL��OAESS CI1V ZiP PIIONE LICENSE• <br /> CL1198O�WOPN � <br /> ❑ NEW ❑ ADDITION ALTEPATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSiOVElFRPL.INSERT ❑ BUIIDINO RELOCATION <br /> VALU�TIONOFWORICICOStOiM�ICRI�L9PWSL�BOR1 O O <br /> 9s � <br /> OE9CR1lE WOHK <br /> / L C <br /> U6EOFBU�LDINO I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED TIiIS AP• <br /> PLICATION AND KNOW TH E SAME TO BE TRUE AND CORRECT.ALL <br /> lE6�LDE9CRiPT10NOFPCOVERTY�SNOWNBEIOWOA�it�C1110URG01'iE31 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> .7 Y �� ,¢Nh �j,fr,- OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HEfiE• <br /> �or_e�oc�_or�— -=y.- INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO <br /> `i GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF' <br /> i <br /> ANY OTHER STATE OR LOCAL LAW REOULATIN6 CONSTRUCTION <br /> �� OT L� � OR THE PERFORMANCE OF CONSTRUCTION. <br /> \ D P F�F�,�� �(..��rLLL� v ��� (+ SION�TURE OF CONTR�CTOR OR AU7NORI2ED AGENT OATE <br /> �� F , a �' - X � ' 7 <br /> ►IIOJECT�DDRESS V4G�Ni5CITYBU51NEuSLICENS O <br /> �� ��2� �� MECMANICAL <br /> PLUMSINO <br /> NO. TYPE OF FIX7URE FEE NO. TYPE OF EGUIPMENT FEE <br /> � WATER CLOSET TOILE A�A COND. UNITS–M.P.EA. <br /> ) BATHTUB REFRIGEfiAT10N UNITS–H.P.Ell <br /> Yj LAVATORV WASH BA31N BOILERS–H.P.EA. <br /> r� SHOWER GAS FIRED AC.UNITS–TONNAOE EA <br /> � KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS–B.T.U. M EA. <br /> ;'-' DISHWA9MER WALL N'"ATERS–B.T.U. M <br /> 7 <br /> ,} LAUNDPV TR�Y UNIT MEATERS–B.T.U. M <br /> 7 CLOTMES WASNER EVAPOMIIVE COOLERS <br /> � WATER HEATEP CLOTMES DRVERS <br /> URINAL VENTILATION FAN <br /> � DRINKINO FOUNTAIN RANGE MOO� <br /> FLOOR DR�IN AIR MANDLING UNIT– C.F.M. <br /> 1 VACUUM BREAKERS STOVE <br /> ROOF DRAINS–RAINLEAOERS METAL FIREPLACE 6 CMIRiNEY <br /> I SINK SERVICE–BAR ETC. WOODSTOVE/FIREPLACE INSERT <br /> t <br /> � <br /> i <br /> i SUBTOTAL BUBTOTAL ! <br /> � VEIIMIT t PERMIT f <br /> '' TOTALFEE t TOTALFEE { <br /> 7 — <br /> � THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FNONTSETB�GK RE�RSETB�CN SIOESE78�CK PUNCHECN UMBER ^ PUNCMECNFEE <br /> NA /'tO `Ij'�" �� I(Y/1�_ 1 fEEl1--� AECEIPTN�C�Q <br /> o� �`J V- U � �� <br /> ` USE ZONE IOt�RE� y���ryT iTE FEEB V�LU�TIOB FEE <br /> �! I� ` � LO� OYES �NO <br /> �C 7 <br /> TYPCO�F�C/yON..ST. OCCUP��NyGYGROUP NOOFOrWELLINOUNIT9 <br /> i � /n � � I D`G� �D�� BUILDING f q��' �j'O <br /> 81LE OF BLUO. NO.OF STORiE9 NA%.GCG.LO� <br /> a�� Z,.��' r N PLUMBING <br /> 'yI MECHANICRL <br /> •1 FIRE SPRINKlE9S REOUIRED ❑ YES O NO oTHER <br /> PEN�LTV <br /> I APPLIC�TION�LC B• PL�NSCHECKEUBV �PPR.fORI55U�NCEBY <br /> TOTAL <br /> ' G�i L •G <br /> ; <br /> ; <br />