Laserfiche WebLink
f,►PPLICATION FOk <br /> '"""ro'"" CO N STRR Ui T I O N "`P"r„ <br /> em w <br /> everett PE M T <br /> BUILDINf3 DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECNANICAL ❑ PLUMBIN6 O SIQN <br /> ppl�EA MML IIDORCl111 CIiY SI> VNONL <br /> �l.fA�2Q/1E �NdtN�iun� .72 ?/-�/�dH'er�'rl�e.� �l�[�eTT <br /> •NCMIIECION YOHER MML DORE49 G�TY IiO VMDNL <br /> f.k�1EP11 CONiR1GlOP M�It�DOHE55 C�M1 tIP a1�ONE UCENSE• <br /> MI: /�ui/c�-�,�i�/i:�rYa C�rsV. g4zy �/�!�/- S. F ��r+�J7` yfi2e8 <br /> MtGN�N�GI CONiR�LTOR MAIL�OORE55 CIfV IIP �uONE UCV15C • <br /> PLUMBMOCON1R1GfON MMI�DORE55 G�IV 2iP vNONE t4H4C • <br /> C1�55Of WOA! <br /> ❑ NEW ❑ ADO�TION ❑ IILTERRTION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUIIDING REIOC�TION <br /> V�lU�f10NOF WOAKICOS�Ot lu�[RI�L$PWSL�BORI <br /> y DFSCNi9E WORK �E �p <br /> k �•ze S���vdiir (,.�eocf Sy`o�e � C.ec�E (,,a�Y /i'efn/m� <br /> � usF or e��uo��a — <br /> 5����� �����y CS�(�e�,Gp� I HEREBV CERTIFV THAT I HAVE READ AND EXAMINEO THIS AI` <br /> tcouoesc' �onOHO�onOOEu�r�5N0 NBEIOWOR�iGCHFOU�COPIESI PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALI <br /> PROVISIONS OF LAINSAND OROINANCESGOVERNING iHISTVPI <br /> � OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE <br /> io�—e�oc�_or IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME T( <br /> I GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> � ANV OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTIOI <br /> OR THE PERFORMANCE OF CONSTRUCTION. . <br /> SIQN�TUR F CONiR�GTOR ON AUTHORIZED�OENT It�TE <br /> FPOIECi�D0AE35 �PV I i5GTY8LI5ME55ltGEN5EN0 , �� <br /> 22 3/ - �.e,���l-"e(l�r �Her�7� <br /> PLUM8INO MECHANICAL <br /> NO. T1'PE OF FII(TURE OR ITEM FEC NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILEiI A/C—ARINOLO UNITS—H P. <br /> BATHTUB REFRI6ER�TION UNITS—H P.EA. <br /> UVATOHY 1 WASN B�S�N� BOIlERS—B.i,U./N.P. <br /> SHOWEP (3A5 FIREO 11�C.UNITS—B.T.U. <br /> KITCHEN$INK 8 DISP FORCED�IR SYSTEMS—B T.U. M EA. <br /> I DISMWIISMER N7ILLMEATER3—B.T.U. M <br /> � ' IAUNDFYTRl1Y UNITHEATERS—O.T.V. M <br /> � LLOTHESw�SMER EV�PORIITIVECOOLERS <br /> � UPINl1l CLOTHES ORYERS <br /> I <br /> O171NKING FOUNiAIN �ENTIUTION FAN <br /> FLOOA ORAIN RANOE NOO� <br /> B�CKFLOW PNEVENTERS W�TER MEATEP <br /> ROOF DRAINS—RnINLEADERS w000 STOVE <br /> SiNK�SERVILE—BnF.ETC� � METAI PIREPUCE 6 CHIMNEV <br /> � PIREPUCE INSERT <br /> I <br /> 1/EAT PUMP <br /> aR5 PIPINO <br /> E%MAUSTFAN <br /> SUETOTAL ! dUSTOTAL <br /> VERMIt f KRMIT <br /> TOTAL FEE f TOTAL FEE <br /> ��+ovi 5[re+c� uE�n 5cte�cK SiDE 5[iBACK PIAN CMECK NUM9ER FEE AECEIPT NO. <br /> usc mve l01 ApE� ��cuir sne FEES VALUATION FEE <br /> ❑YES ONO <br /> BUILDING S <br /> M1�E 01 CnNS� nf.CIIPANCY GROUP NO O�OWFIIING 1IN115 <br /> PLUMBING <br /> 5�1[O��CIDu NO 0�SIORi[S 1.UK OCG IOPD <br /> MECHANICAL <br /> OiHER <br /> FIHE SPqINNLERS REOUIRED U YES U NO STATE BUILDING SURCNARGE <br /> STATEENERGYSURCHARGE <br /> uVip:chp•IaCf. O• n�INSCHECREOBY �PCNfON15SU�NGEBY <br /> PUBLIC WORKS <br /> TOTAI <br /> PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PfiOPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />