Laserfiche WebLink
�'PLICATION FO�:� ���,�„ <br /> '".E"`°""' CONSTRUCTION O <br /> GT'�OF <br /> everett PER11�IT <br /> TO 9E COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDItJG DEPT. <br /> 259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> M�IL�DORE54 CITY ZIP PNONE <br /> Ow�ER . _ � �7 il , � / I � 7 � 5 �. . �._!_ ��j;,1/,"C� <br /> �Cv. --.J� 5�'7L �1�� r - /�' �'� -"�l N�"=j.. <br /> �MGI TEGi ROE&ONER Mq(�DDRE59 �CiiY 2iP _ P��ONE <br /> ( �/ I_/ <br /> OENEMICONTR�GT0f1 'IAAIt��DHE99 Litt ZIP PNOnE UCEt�SE• <br /> MECHANICALCANTMCiOfl MAII�ODPE59 Clrv 2iP FHUrvE LiCENSE• <br /> PLUNBINOCONTMLT011 M�IL�ODRESS CItV 2iP FNOt�E I�CErvSE• <br /> Lt�990F WORR <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION_ ❑ REPAIR ❑ DEMOLITION ❑ N'OODSTOVE/FPPL.INSERT ❑ BUILDING REIOCAT10N � <br /> \•AIU�pJM Oi WORN(fAST OF MATEPI�LS PLV91�801p <br /> .4' H <br /> J(� C O i-.� n <br /> m <br /> BESGNiB�M'ORN " <br /> � l� \ <br /> uscoreuaoiHo I HEREBY CERTIFY THAT I HAVE READ AND EXP.MINED THIS AP- <br /> PLICATION AND KNOW THE SAMETO BE TRUEANDCORRECT.ALL <br /> LEO�IDESCRIPTiONOfPROVEPTYISMO�lNBELOWORATT�LNFOURGOPiES� pROVI510N50FLAWSPNDURDINANCESGOVERNINGTHISTYPE <br /> OFWOfiKWIIIAECOMPLE7ED`NITHWHETHERSPECIFIEDHERE- y �j <br /> ior_a�oc�_or INORNOLTHEGRANTINGOFAPEFMITDOESNOTPHESUMETO H � <br /> GI`!E AU7HORITY TO VIOLATE OR CANI'EL THE PROVISIONS O� tJ) <br /> ANYOTfiERSTATEORLOCALLAWREGULAi1NGCONSTRUCTION � <br /> OR iHE PEflFORMANi,E OF CONSTRUCTION. � <br /> SIGNATUBE OFGONiRAGiOIi OR�UI/IOR12ED AGENT DAt[ <br /> X � 7 _. d��-- � <br /> i��. , -., ; ; ;':1� �� � _ . �,� � � <br /> GHOJECT DPESS APPLCeNPSdTYgU51NES5LICCN5EN0. �,y <br /> k � ; . _ gz <br /> ) i'rP ) '. <br /> PLUMBINO _ MECHIINICAL <br /> b <br /> NO. TYPE OF FI%NFE FEE N0. TYPE OF EOUIPMENT FEE �-7 N <br /> K � <br /> W�TER CLOSET TO�LE AIR COND.UNITO-N P.EA. O <br /> BATHTUO REFRIGERATION UNITS-�HP.EA. 's] <br /> LAVAiORY WASHB�51 DOIL[RS-H.P.EA. =] <br /> GAS FIfiED AG UNITS-TONNAGE EA ' T <br /> � SMOWER �-� N <br /> KITCMEN SINKB DISP. FORCED AIR$YSTEMS-B.i.U. M EA. Q4 <br /> DISMWASHE7 VJA�L MEATERS-B.T.U. M � � <br /> LAUNDRYTPAY _ UNITHEAiEFS-BT.U. M N <br /> CLOTHESWASHER _ EWPORAiIVECOOLERS n <br /> WATERHEATC.R CLOTHESDRVERS � <br /> URINAL VENTILF710N FAN <br /> DPINN�NG FOUNTAIN �RANGE NOO� _. <br /> FIOOR DR�IN AIR HPNDLING UNIT- GF.M. � <br /> VACUUM BREANERS __ S70VE <br /> ROOF DRAIN.S-RAMLEADERS MGTAL FIREPLnCE d CHiMt1EV � <br /> SINK SERVILE-BAR ETQ) WOOOSTOVE/FIREPLAGE INSERT <br /> H <br /> 1A <br /> H <br /> F-i <br /> SUBTOTAL SUBTOTAL _3 � <br /> PERMIT 3 PEPMIT 3 <br /> TOTALFEE • TOTALFEE 3 <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSU�dI��L <br /> iPONT SETBKN REAP SEiBACK SIOE SETB,�CN VL�N CHCCn NUMBER PLAN CHECk IEC <br /> p�E P[CCIPt NO <br /> USEZONE IOTANEA y��,WiSITE FEES V�LU�TIOH fEE <br /> pYES f1^IO <br /> TYVEO�CONST. OLCUP�NGYGPOUP NO.OFOWElUNOUNIT9 <br /> BUILDING s <br /> SISEOFBIIXl NO.OFSTDPIES M�%OCG.LO�O � - <br /> PLIIMBING <br /> M[CM4NICAl <br /> FIRE SPRINKLERS REOUIRED ❑VES ❑ NO <br /> OTNER _ <br /> PENPLTY <br /> APP4WT104ACf:.BY PUNSGNELKEDOV AFPR.fONISSU�NCEOV <br /> TOTAI <br />