Laserfiche WebLink
ary�,o,�, `�1 PP LI CAYIO,N FO K ,,,,�„ <br /> CONSTRUC�'ION e <br /> everett PE RM 1°� <br /> TO BE COA1PlETEO IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259•8745 � COMBINATION � BUILDING � MECHANICAL � PLUSABING ❑ SIGN <br /> OWNEN N\IL�D�RE55 CITY .I1 ZIP PMONE <br /> —� (��L17'(�!,l�,) _���'..y.`.."'�2_--��eP.�`l� Ll/.¢��Z(c, aZS�7 —yO77 <br /> APCNIE,,G/IOA/DE51� ER IIMLAODPES CITY ZIP VHONE <br /> _.Li�ldA� '���i, �,�-ri� /� �����5� �ZNC�1�'P��7va�� �'ig(� J7tfG.�ft <br /> OENER/�LCONIqACOA M11 �pD,�R/ES5—�7-- -- CIfV PH E —� UCENSE• <br /> �iH�Lf.jL L(�i',��r/'n /Y�>��[ /-�, � �i�.'rlf� ��� .ZSJ -�J'77 S( /4• S(c <br /> MELH�NIC11lCOMNACIOq M�IL�DDRES CIiY T— ZIP PHONE IICENSE• <br /> PIUMBINOGONTR�GTOfl M�Il�U0RE53 CIiY ZIP PNONE UCENSE• <br /> CUSS Oi WONN <br /> � NEW ❑ ADDITION ❑ AL'fERAT10N ❑ REVAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERL ❑ BUILDING RELOCATION <br /> ' W�LONOfWONKICOSTOfMRILRUL5PLV5L�UOPo <br /> '�443 U . �v <br /> oescni E WORI( . / <br /> U ' <br /> USE 0�BURDING • <br /> � . _/yP,�� �V� I HEREBY C RTIFY THAT I HAVE READ AND EXAMINE THIS AP• <br /> lI?T PLICATION AND KNOW THE SAME TO BETRUEANDCqRRECT.ALL <br /> �ec�i SG�NIPTIONOiPROPERIY�SHOWNBELOWORAiTRCNFOURCOPIE51 pROVISIONSOFLAWSANDORDINANCESGOVERNIN(;THISTYPE <br /> OF WORK WILL BE CUMPLETED WITH WHETHER APECIF;ED HERE- <br /> io�_e�oc�—ov IN OR NOT.THE GRANTING OFA PERMIT DDES NOT PREcUME TO <br /> � � I --7- GIVE AUTHORITY TO VIOLATE OR CANCEL THi= PROVISIONS OF <br /> OfY-��.r f1 S_ /'� / dZ�� I ANYOTHERSTATEORLOCALLAWREGULATI�GCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTIUN. '/ <br /> SICaNATURE OF CONTPACTOii OR AUTMORIZEO AGENI DATE 'r�S�S <br /> c- ��-2 g -� X <br /> FNOJCCiRDORf55 ( } APPLICMN 5 ITYBUSINESSLIGENSE , . <br /> $r7� qi�d��i�7"7.. . ���� �l' �l !�J <br /> PLUMBINO MECHANICRL <br /> NO. TYPE OF FI%TUHE FEE NO. TVPE OF EOUIPMENT FEE � <br /> � WATER CLOSET(TOILEI) AIR COND.UNI75-H.P.EA. _ <br /> � BATHTUB _�O FEFRIGERATION UNITS-H.P.EA. <br /> � LAVATOf7Y�WA5HBASIN� BOILERS-H.P.EA <br /> SHOWER GAS FIRED AC.UNITS-TUNNqIuE EA <br /> Z� KITCHEIJ SINKd DISP. O FORCED AIR SVSTEMS-B.T.U. M EA, <br /> Z OI�HWASHER WALL MEATERS�-B.T.U. M <br /> LAUNORY TRAY �UNIT HEATERS-B.T.U. M <br /> CLOIHES WASHER EVAPORATIVECOOLERS <br /> WATER MLATER CD CLO�MES DRYEfiS � Sd <br /> URINAL VENTILATION FAN �IZ OO <br /> DRINKING FOUNTAIN 7 RANGE HOOD (,7 <br /> FLOOR ORAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUM BREANEfiS __ STOVE <br /> ROOF DRAINS_RAINLEAOERS METAL FIREPLACE 8 CHIMNEY ��(� <br /> SiNK SERVICE-BAR.EiC.) WOOD5TOVE/FIREPLACEINSEHT <br /> SUB TOTAI W SI1B TOTAL S n'�,7� rjU <br /> PEflMIT S PERMIT f <br /> _ TOTALFEE S � � TO7ALFEE f �� <br /> THIS PORTION TO 8E COMPLETED BY BUILDING DEPT. PERSONNEL <br /> 1HONIFiIBACI fILBp5E1BACK SIOESEiBACK PLANCNEC NUMBER PIANCNGGHFEE <br /> 2 V ('(r� �0 OS�`F7�7 FECCr �l J' �4iCli�W� <br /> USE.:ONE LOIn11E4 — �� <br /> I� 9 � � //�� V�CANi511E FEES VALU�TION fEE <br /> " J /i)I'. L. S /'�!. OVES jPNO _ <br /> IYPEpfCONST OCCUPANGYGqO11P NO.OFOWELIINpUN11S <br />.. �' /�' ` �'r / 2� BUILDING E -- ' `�(�n � <br /> SiZE Ct{'BLUO NU Of e�OlilES M�a,pCQ LO�D Il <br /> �/ 3;� � ,(� PIUMBING r� <br /> _ c,:�Z.-t20 <br /> MECHANICAL 'L � _/� <br /> FIRE SPRINKLERS REOUIREO ❑ YES " NQ �L <br /> � OTHER <br /> PENALTY <br /> APPUC�IIO�4AGC.BY PI.nNSCM[CNEpOV RPPR.FORISSU�NCEOV --- — <br /> TOTAL �,8s1 �1/+ <br /> �� �� �ff �St <br />