Laserfiche WebLink
i : <br /> ' �-c,P^PLICTATION FOi,�' <br /> � '°.E�.,°`"° C`J N S 1 R U C T I O N everen <br /> Gn�F <br /> � everett PERMIT <br /> ' 6UILDING DEPARTMENT I <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE FRINT <br /> ❑ DEMOLiTION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> �. OWNf.F M4ILADDRESS CItY ZIP VMONE <br /> �v��E'r ,;�u J,,�u �9ary <br /> AqGHITEGTOROESIGNEF MAILADGRE55 G'Y ZIP PIIONE ' <br /> �,�,�TAM�ti� �oli,�s�oJ Y�,� 9fki S�9ss�7 <br /> GENEF�LCONIRPGLOR MAIIAC'ICE55 C�n' ZIP GHpryE LICENSE+ . <br /> " �Li /.�/fliTco.ir� y/� �(/, /zT?--'Y 5E/'T�G �'"/9'� �61,rf`s's�1:o�/✓HRSSoIni <br /> i MtCNANIGLCONTR�GTOq M�4�pORE55 CItV ZIP PMONE UCENSE• I, <br /> 3 I <br /> � oLUMBiNGCONtAACIG�i MMLnODRE55 CITV 2iP PnONE liC[NSE� �., <br /> ' CLRSSOF WJRN <br /> . ❑ t1EW � ADDITION ❑ AL7ERATION '� REPAIR ❑ OEMOL1110N ❑ WOODS70VE/FRPL.INSERT ❑ BUILDING RELOCATION . <br /> � VAlWT10NUi JAKICOSTOFI.IALERInL5flU5L<OOR� I <br /> !-v�G c �,v tiia'�L�rr��ro iz d�G-`� ' <br /> � OE�^.FIOE WORN T I <br /> ; �•'�icOwpGc /1i7a�ul� Gt.�.vB�tATo2 ' <br /> i <br /> USE OF BUIIDiNG � <br /> � / I HEREBY CERTIFV THAT I HAVE FEAD AND EXAMINEU THIS AP• j <br /> /��i�A/M CA/�IJ PLICATION AND KNOW THE SAME TO BE TRUE AND COFlFECT.ALL <br /> , L[GALOESCRIPTIONOF>RGPERLY�SHOWNp[IOWORPiTACHFOURCOPIE51 PROVISIONSOFLAWSANDORDINANCESGOb'ERNINGTFiISTYPE <br /> � OF WORK WILL BE COMFLETED WITH K'HETHER SPECIFIED HERE� <br /> �oi_e�oc�oF_ IN OR NOT.TI1E GRANTING OFA PERMIT DOES NOT PRESUME TO <br /> � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF � <br /> i ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUC710N ', <br /> � — OR THE PERFORMANCE UF CONSTRUCTION. . il <br /> SIGNnTURE OF G'JNiqqCTOR OR FUTMORIZEO AGENT L`qTE <br /> f � L!�K( ""' /v'�� �—��—Op I <br /> i <br /> � PNOJECTAOUHE55 APPLiC�NiSCrtYBU5�NE55LiLEN5EN0 <br /> ' � 26 o S - !; � S'-f- <br /> , <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF F�aTURE OR ITEP.• FEF. NO. TVPE OF FOUIPMENT FEE <br /> W nTER CLOSET�TOILET� A/C—AIHNOLG UNITS—H.P. <br /> I BATHTUB P.[FqIGERATIpNUNITS—HP.EA. <br /> � LAVATORY�WASM9ASIN� BOILERS—B.T.U/H.P. ' � <br /> � SHOWER GAS FIRED A�C.UNITS—flT.U. <br /> KITCHEN SINH 6 DtSP. FORCED AIli SVSTEMS—B.T.U. M EA. <br /> � DISHWASIIER WA�LHEATERS—B.T.U. M <br /> , ' IAUNORVTRAV UNITMEATEHS—B.T.0 M � � <br /> ; CLOTHES WASMER EVAPORFTIVECOOLEfl$ � <br /> UFINAL CLOTHES Di7YERS <br /> � � � ORINKING FGUNTAIN VENTILhTION FAN <br /> FLOOP DRAIN RANGE HOOD <br /> i <br /> BACKFIOW PREVENTERS WA1ER HEATER <br /> ROOF ORAINS—RAINIEADERS WO00 STOVE <br /> � $INK�SERVICE—BAF.ETC.� ME�AL FIREPLACE 8 CHIMNEV <br /> IFIREPLACEINSERT <br /> I HEATPUMP <br /> ' GAS PIPING <br /> iEXHAUSTFHN <br /> i <br /> SUB TOTAL S SUBTOTAL <br /> I PERMIT f PEPMIT <br /> i TOTALFEE S TOTALFEE <br /> � � FRpNi SEIOACN RFAR SEIBPCN SIOE SETBAGH PLAN CHECK f:UMBEH FEE flECEIPT NO. <br /> �- $c���9yr�� �5= <br /> � usc zor+e �_ OT RREA vncnr�r sir� FEES VALUATION FEF <br /> � �j� ❑YES �XNO " <br /> — BUILDING S <br /> tYPEOFCONST. OCCIIPPNCYGPOUP NOO�DWELLINGUNITS <br /> �� H —� � PLUMBIN(i <br /> 512E OF BLDO. NO OF SiORIES Mnx.OGC LOAp <br /> MECMANICAI <br /> N.�. <br /> OTHER <br /> FIRE SPRINKLERS REOUIRED ❑ VES NO <br /> S7ATE BUILDING SURCHARGE <br /> STATEENEAGYSURCHARGE <br /> APPLiCaiION ACL B� PLnNS CNECNE�J BY RPPR FOfl iSSIIRNGE BY <br /> / /` � PUBLICWORNS <br /> %`�� /.!' <br /> // yL(./ �« /�� 70TA1 <br /> PROPERTY OWNERS AfiE RESPONSIBLE FOR DETERMINING ALL <br /> � PROPERN LINE LOCATIONS AND RELATED EASEMENTS. <br />� "��c-�.S.-„_._... _.... . ._ ,_. . . _..... . �_..___ _. . . <br />