Laserfiche WebLink
�� . <br /> �::�PPLICATION FO:�' ���,�„ <br /> «:«"" CONSTRUCTION O <br /> everett PERMIT <br /> BUILDING DEPARTMENT <br /> 259•8745 TO BE COMPLETED IN INK• PLEASE PRINT <br /> O DEMOIITION ❑COMBtNATION � BUILDiNG ❑ MECHANICAL ❑ PLUMBIN6 ❑ 316N <br /> OWHEN MI1IL�DDPESS CIiY 21P PMONE <br /> Za l nl. R�r1�m��l'�r ,����.� t,.�e.`Ei�.oK ����-ct.l 9a�.zo 1 <br /> MIT CT0110ElIOMER M�IL110�PE58 Cltt Z�V P ONE <br /> " ONTNI1C/OA M�IL ApDRE9S ��n' z�P PNONE IICENSE• <br /> �.v��Fv �no'��- �a�s - L4�`` 5�. �_�P�� 9Pa�Y 337 35iV TIf�C'1�1�IQis4�ry <br /> MECN�NiC L CONTR�CTOq MML�OOPE9S �n' P P ONE LICE SE <br /> � M�IL��DHE9'J CIiY 21P PI10NE LICENSE• <br /> RYMlINO CONTPII <br /> CLA9SOi WOf1R <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ DEMOLITION ❑ W00f1STOVE/FRPL.INSERT ❑ BUILDINO REIOCATION <br /> W1lV�TIOMOFWONRI�gTOFM�IERIQ5VLU9LABOPo ��^L �O I <br /> � I <br /> OEBCPilE WONK ' ��t <br /> ��' an6� re� ao�P �'oo��- . ba a� ` or�to� a�' ,C�l.c���/���c i <br /> ueeorsuaouw I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• ' <br /> '(,(� �� C �' PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT,ALL <br /> LEO�LOElCRiPf10NOfP110PEPTYISHOWNBELOWOR�1s;MFOURGOPIE ROVISIONSOFLAWSANDORDINANCES60VERNINGTHISTVPE <br /> /�'r /� fU�y� OFWORKWILLBECOMPLETEDWITHWHETHEflSPECIFIEDHERE- <br /> �or�s�oc�.�l.Lor � IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> �� � ^ ti[1 J GIVE AUTHOHITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br /> d �( Z ANYOTHERSTATEORLOCALLAWREOULATINGCONSTRUCTION <br /> / OR THE PERFORMANCE OF CONSTRUCTION. <br /> �/Q_(/� /� S O/1 D� � 'L � � SION�TUN TRACTON OR A O IZE AGENT OATE <br /> Y "�� X �l3 �6 <br /> PPOJEGTII ORESS � APVLIG�NT9CI�YBUSINESSUCENSENO. <br /> �2�-1Mv r <br /> iLUMlINO MECHANICA� <br /> NO. TYVE OF FI%NI1E FEE NO. 7YPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILE AIR COND.UNITS-H.P.CA. <br /> BATHTUB REFRIOEPAiION UNITS-H.P.ER. _ <br /> L�VATORY WA9H 811SIM BOIlERS-H.P.EA _ <br /> 9HOWER QAS FIRED AC.UNITS-TONNA6E EA <br /> KITCHEN SINN 8 DISP. FORCED AIR SYSTEMS-B.T.U. M EA _ <br /> DI9HW�SHER WALL HEATERS-B.i.U. M <br /> IAUNDRVTR�V UNItHEATERS-B.T.U. M <br /> CLOiHE3 W.�SHER EVRPORATIVE COOLEFlS <br /> WATEF HEATER CIOTHESDRYERS <br /> URINAL VENTILpiION FAN <br /> ORINKINQ FOUNTIIIN RANGE HO00 <br /> FLOOR DRAIN �IP HRNOLINQ UNIT- C.F.M. <br /> V�CUUM BRE�KERS STOVE <br /> ROOF DRAINS-RAINLEAOEFS METAL FIREPLACE 6 CNIMNEY <br /> SINN SEHVICE-BAR.ETQ WOOOSTOVE/FIREPLACE INSERT <br /> BUBTOTAL SUBTOTAL 1 <br /> PERMIT t PENMIT ! <br /> TOT�LFEE t ' TOTALFEE � <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FqONTSETB�CR AE�R5EIB�GK SIDESEIB�GN PL�NCNECNNl1A�BER • PL�NCNECKfEE <br /> FEE �ECEIPINO. <br /> USEIONE LOI�REA y���NT51LE FEE! V�lU�T10N FEE <br /> OYES ONO <br /> rYPEOiCONST. ��UP�NLYGROUP NOAFOWELLINGUNITS <br /> BUILDING s <br /> SRE Of BLDO. NO Of 510PIES M�%OGQ LDAO <br /> PLUMBING <br /> MECIIRNICRL <br /> FIRE SPRINKLERS REOU�RED O VES O NO <br /> OTNER <br /> PENFLTY <br /> �OP��pAt10N�CGBY PLRNSCNECNEOBY �PPR.FORISSU�NLEBV <br /> TOLAL <br /> ���~ <br />