Laserfiche WebLink
����fPPLICATION FOYa`' evcrett <br /> the Everymen C 4 N ST R lJ C T 0 O N � <br /> cirr or <br /> everett PE �MlT <br /> BUILDING DEPARTMENT <br /> 259-8�45 TO BE COMPLF.TED IN INK- PLEASE PRINT <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING MECHA�ICAL ❑ PLUhSBING ❑ SIGN <br /> O� ' � � ) MAILAODR[59 �1����� // ����� �IIONE�59 3�19C� <br /> j/ie , � ����� �'Z6 i ;%I <br /> •NGMIlEC10f1UE91G1lER MAllPD011E55 GIP/ IIP PIIONE <br /> GENEIiRLCONiRRCIOR M4ILAODl1E55 GIIY ZIP PIIONE ��GENSE• <br /> M[CHANiCqLCONiPPGiOfl MR�Lr1DORE55 CLY JP PHONE LIC[NSE• <br /> ��l�CON144LIOR M�Il�O�IlE55 L4Y ZIP PIIONE ��CENSE• <br /> GL�55 OF�40RK ,�.�j <br /> ❑ NEW ❑ ADDITION ❑ �LTERATION ❑ REPAIR ❑ DEMOLITION {�WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATIJN <br /> { <br /> WIWiiON O�WORNIC09�Of M,11CfU�LV VLU9 L�BON <br /> D[SCRIO[VIOnK <br /> �� ll//11 , <br /> �I �,77� � <br /> us�q`- nouia � n I HEREBY CERTIFY THP.T I HAVE READ AND EXAMINED THIS AP• <br /> � %�/J <br /> PLICATION AND KNOW'fHE SAME TO BE TRUEAND COFRECT.AI.L <br /> �eae�oes ni IPJNOFVROPEPrv�5M0 +neio ORAITPLNF ❑RGOPIE51 PROVISIONSOFLAWSANDORUINANCESGOVERNINGTHISTVPE <br /> Of WORK Wll L BE COI,APLETED WITH WHETHEFi SPECIFIEU H�RE- <br /> lOi—BLCGI�—OF IN OR NOT.THE GRAPiTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHONITY TO VIOLATE OR CA�CEL THE PROVISIONS OF <br /> ' ANYOTHEPSTATECRLGCALLAWREGULATWGCONSTRUCTIUN <br /> OR TNE PERFORMF�NCE OF CONSTRUCTION. � <br /> SIGNFIUH ONiRACTCR OR AUTIIOR ED AGENT OATE <br /> / � � <br /> X - ,C� /7 - �' �'. <br /> PPUJECIApp0E55 ! AP LI PNiSCILY9U51NE55LICENSENU <br /> � �/ ! 1 �` ��1 E�1 - <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TUHE FEE NO. TYPE OF EOUIPMENT FEE <br /> WdTEP CLOSET�TOILETI AIR COND. UNITS—H.P.EA. _ <br /> BATfiTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY IK'ASN 6A51 W �OILERS—H.P. EA. <br /> SNOWER GAS FIRED AC. UNITS-1'ONN4GE E0. _ <br /> KIiCHEN SINKL�ISR FORCED NR SYSIEMS—B.T.U. M EA _ <br /> OISHWASH[R WALLHEATERS—B.7.U. M <br /> LAUNORYTRAY 11NITHF.ATERS—B.T.U. M <br /> CLOiHES WASIIER EVAPORATIVE COOLERS <br /> WAIER HEATER CLOTHES ORYEPS <br /> Uf7INAL VENiILATION FAN <br /> DRiNKING FOUNTAIN RANGE HOO� _ <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. _ <br /> VACUUM BREAKERS STOCE _ <br /> ROOF�RAINS—RAINLEADERS METALFNEPLACEB CHIMNEY _ J� <br /> SINK�3ERt�CF—BAR,ETC. WOODSiOVE/FIREPLACE INSERT [� <br /> SUB TOTAL SI1B TOTAL 5 C [_J_ <br /> PEFlMIT S PERMIT S <br /> � <br /> TOTALFEE S _ TOTALFEE 5 <br /> THIS PORTInN TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> 'RONf5F10IGN f1F.AR5EIBACH SIOESEIBr1GH �LANCNECNNUMOEN PLANCHECNFEE <br /> fEE �ECEIPi NO <br /> VSE LONE ��'t ARt� ypCRNi SIIE <br /> FEES VALUATIOH FEE <br /> ❑YES ONO <br /> �YFEOfCON51. OCCt1PANLYGROUP NOOFDWELUNOUNIiS <br /> BUILDING 5 <br /> 51ZE OG OlDO NO Of SiURIES MAX OGG.l04D <br /> PLUMBING <br /> MECH�NICAI <br /> PIRE SPRINKLLRS REGWRED ❑ YES ❑ NO <br /> OTHER <br /> PENALTY <br /> <VP�ICAiIONRCC DY PL�NSC�IECNCO�Y APPR fO0155UANCE�Y <br /> I TOTAL � <br /> �V\ <br />