Laserfiche WebLink
,�.., i <br /> �` � �A`',.i�PLICATI�N FO� <br /> .�_.;�:. <br /> �'; fM EvaOrNn �O N S�'R U CT I O fd �ve��n � <br /> ' �T�v�.CIfYOf <br /> � � :everett �E �MiT � i <br /> BUILDING DEPARTMENT I <br /> 259•BT45 TO BE COMPLETED IN INK- PLEASE PRINT i <br /> j O DEMOLITION ❑ COMBI;JATION ❑ BUILDING ❑ MECHAt�11CAL �"PWM6ING ❑ S13N I <br /> + OWNEfl ,I �+�R���NE55 CITY ZIP PIIpNE <br /> �� ���Q(P �>>C�%�i �C� lC(f C�'V- /7[ "7- /li�i�l��� .� �l2_ ;��`�)_�_�� ���i <br /> �; �ncwrcc�onoeswr+en Mu�nooness cm zir rnone <br /> r <br /> � OENE�ALCONIMCIOA M�ILAOORE59 CIfY 21P PIIONE IICENSE• II <br /> I <br /> AIEC���NIWLC011IIIAC100 M1ILAOORE53 CIIY 21P Al10NE UGENSE• , <br /> 1 <br /> � PWi•�OIH�GO����AGi01i M�ILADORE53 C�1V ZIP PIIONE LiCENSE• <br /> � ti�t���zr1G_ <-���„ f�tc��i�` �'�� .� I�r���� t- i �Y�v��ri U�;��i��� l,�a�'.. F.(.'Z- /��HIL,�I�I'�;�'Jc�� <br /> �+ cussorwonK � ' / <br /> ❑ NEW ❑ ADDITION � ALTEfiAT10N ❑ REPAIR ❑ DEIAOLI110N ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING �ELbCATION `� <br /> �; v�LW�ioNOlwonk�co9lorrnnlEnuLsrWSL�eoR1 <br /> 1 <br /> 1 <br /> ° oescnieE wonK <br /> ��; .,/�n:�� L � �1�� �l � �l�l� � �' � � �� l� �l� (l � � r�1 ir( , � <br /> �. use or ewiowo , � �� <br /> � \�' � C; I HtREBY CERTIFY THAT I H�VE PEAD �NU EXAMINFD TNIS AP� <br /> ��� � � ��� � � I� � - PUCA?IONAPIDKNOWTHESAME70BETRUEAIJDCORRECT.ALL . <br /> IEO�LGE5CI11P110NOFPROPERfY1S11DWNUELOWORAIGCHFOURCOPIES� pRpVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE � <br /> OF WORK WILL 9E COMPI.ETED`NIThI WHETHER SPECIFIED I1E9E• <br /> `�� �o�—ewcK_o� IN OR NOT.THE GRANTIN�OFA PERMIT�OES NOT PPESUME TO <br /> �� GIVE AUTHORITY TO VIOLATF OR CANCEL THE PROVIS�ONS OF <br /> � ANY OTHER S7ATE OR LOCAL LAW REIiUL/1TING CONSTRUCTION <br /> OR THE PEFFCAMANCE OF CONSTRUCTION. <br /> ,� SIONATURE O FONfqAC10R OR AUTHORIZED�GEN� OAtE <br /> � X 1��/�� --- lx� <br /> '] '/ ),�—;�(7 l c�.� ;; —i/`� U <br /> id PPOJECI�OORE99 , APP4GANT9GItY�U5WES5LICEN5EN0 <br /> I <br /> .f i��,C(1 � )L._-�-— <br /> ' PLUMBINO MECHANICAL <br /> ,�� NO. TYPE OF FI%TURE FEE NO. TYPE�JF EOU�PMENT FEE <br /> '-� WATEHCLOSET�TOILEn _ AIRCOND. UNIiS-H.P.EA. <br /> BATHTUB REFRIGERAIION UNIIS-H.P. EA. <br /> � LAVAIOFV�WASHBASIN� BOILERS-H.P_EA. _ <br /> �i SNOWEfi OAS FIOEDAC. UNIIS-TONNAOE EA <br /> � KI�CHEN SINKB DISP. I fORCED NR SYSIEMS-B.i.U_M EA Y�� ` �__ <br /> DISIIlYA511ER �M1'A�L HEAtEf15-B.T.U. M <br /> � LAUNDRY 1flAY UNIT HEATERS-61.U. M __ <br /> ; CLOTHES WASHER EVAPORATIVE COOLERS _ <br /> t WATER HEATEF CL0IHESORVEiiS __ � <br /> � URINAL VENTILATION FAN <br /> � DRINKINO FOl1NTAIN RANGE HOOD <br /> �� FLOOR�RAIN AIR I{qNULING UNIT- C.F.M. __ _ <br /> .� VACUUM B(iEAKERS _ STOVE _ <br /> �I ROOF DRAINS-RAINLEAOEfiS METAL FI(7EPLAC _E d CHIIdNEY <br /> j SINK SERVICE-BAR E1C.) WOODS OVUFIREPL EINSERT <br /> y — a <br /> �i — — — <br /> I —— — — <br /> i <br /> .� <br /> �� — — — <br /> SUBTO7AL GUBTOTAL t <br /> �� PEfIMIT S PEFMIT S <br /> ' TOTALFEE a 70TALFEE S <br /> ' TH!S PORTION TO BE COMPLETED DY BUILDING DEPT. PERSONNEL <br /> i PONI SEIOAGN lIE4q SEIBACN SIUE SEIOACN PLAN CIIECK NUMOER PIM1N LIIECN fEE <br /> I <br /> �EE �ECEInINO <br /> . USE 20NE l01 nf1EA y�C�Nf SIIE <br /> ❑YE9 ONO FEES �AlU11TI0N fEE _ <br /> � IYPE Oi CONS7 OCCUPnNCY 6f100P HO.OF OWELLINO UNI15 <br /> � 9UIl�IN4 S <br /> SIZE OF O100 NO Oi SlOfllE9 MAX OCC.LOAD — <br /> l PLUMBINO <br /> 'i 1- MECH�NICAL <br /> ! fIi7E SPRINKLERS fiEOUIRED ❑ YES ❑ NO <br /> or��en <br /> PENALTV <br /> AopIlG�11011 Af.f. pY PUNSCIIEGNE�BV RPPp.fOR 19511MlLE 9Y — <br /> TOTAL <br /> i I . <br /> i .::i:. , .. .. . �.. , _ . . . . � .. '. � . -.. . . . - ' . . . . . . . . . . . . <br />