Laserfiche WebLink
��.E,.,,,�� APPLICATION fOR <br /> ""°` CONPERM TTION '"e <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK • PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> OKN�F MNI�pOHf�S � ('rtV <br /> .a�� ZiP VNpN[ <br /> 3,rR� e � y� � ,xm,S r SLv s- E� e�e e7 �p�o .�.r"- .r.z <br /> �4��� P M4iq�DwF55 '.-��V ,f'GM S f <br /> SMh Cur-rTYRt��ItS 73 �y `/'�� ��QIUZ /4� J�'�.37U Pn�Nf� � �3 .2�J"G:, <br /> r�ir�lN�� l'uJ� �.Y�� M (U F55 <br /> �/��V� . C �� liP vuONf �nlfrCH� <br /> �,�� C'6i��CF} c.��� 73/�I vyrh ��I�[ lG2—NL � �3'7c> G j 3 ,�.p� � <br /> i Cor� �oa u on ess arv riv rr�oNe 4 <br /> �U�• <br /> v�UMB�N��CUNiR�UpR Mu1sODRE55 l.in liv w�UNE a �a � <br /> .u�r�ti� . <br /> ci�ssar woa. <br /> � NEW ❑ ADUITION ❑ ALTEFATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRFL INSERi ❑ BUILDING RELOGAT�OI� <br /> v�iu���nr�or w�in.�cosr u u�rcni��s n�i�s��eon� <br /> � OOU <br /> �n scroHi w;�ii„—�7 . <br /> t..ti �cc � C' aLT • -- _ - - <br /> util Of Bl:ilO�NG "� - - <br /> 1,l � 1 �I I HEREBY CERTIFV THAT � HAVE READ 4ND EXAMINEO THiS af'- <br /> PLICATION AND KNOW 7HE CAME TO BE �RUE ANDCORRECT AL L <br /> ��:r.�ioesenintior�orvAoaentris OWNBELOWOR�14CNeyq=0�iF5r PROVISIONSOFLAWSANDOFOINANCESGOVERNINGTHISTVPf_ <br /> ����0 fl�i��^_aF 7 �� OF VyOFK WILL AE COMPLETED WITH WHETHER SPECIFIED"ER6 <br /> �� GIV�ERA�HOR TV RO�IO A�E OR CANICE��T 1E PROV SSONS OF <br /> ANV OiHER STATE OR LOCAL LAW qEGULATING CONSTRUCTION <br /> OR THE PEFFORMANCE OF CONSTRUCTION. <br /> SIGN�iURE Ui CON1q�CiGF OR AU qi [p PGf.Nf ��i41[ <br /> x �.�/ > <br /> -�t- i-i� ;;� <br /> �R(LFCi�OURESS •PC��f,�H�S b1Y BUSiNE55 Uf,lNR!NO � <br /> / 1 00� k r s �`r <br /> PLUMSIN6 MECHANICAL <br /> NO. TYPE OF FIIRUR!ON ITEM fE! NO. TYP!OF EOUIPMENT FEE <br /> WATER:LOSET�TOILETI AiC—�iMNUL6 UNIT 5—H P <br /> BATNiUB REFRIGERATION UNI7S—H P EA <br /> UVATpRY�W�SM BAS�NI BOILENS —B T U iN P <br /> SMOWER 6ASFIREDAC UNITS—B7U <br /> NITCHEN SINN 6 DISP FORCEO AIR SYSTEMS—8 T U M EA <br /> OISt:W�SHER W�LLNEATERS—BTU M <br /> UUNONVTRAV UNITMEIITERS—BTU M <br /> CLOTHE$W�SHER EVAPORnTIVECOOLENS <br /> URINA� CLOTHES OBVERS <br /> DRINNING FOUNT�M YENTILATION F�N <br /> FLOOR OR�IN RnNGE HO00 <br /> BACRFLOW PREVENTERS WAiER HEATER <br /> _ NOOFpRAINS—P�INLEAOERS W0f1p5TOVE <br /> SINN ISERVICE—BAR.ETC� METAL FIREPU�E 6 CHIMNEY <br /> FIREf'LACE INS!'RT <br /> MEATPUMP <br /> CAS PIPINO <br /> ExHRUSTF�N <br /> fUlTOTAL t fUlTOTAL <br /> PlRMIT 3 P[RYIT <br /> TOTALFE[ f TOT�IFiE <br /> ����v�sf�n�� . ut.n sE�B•r.. 5roE sEre�CK ��N CHEC NUM9ER FEE ;�) RECEIPT NO <br /> i� ' �:-��; ��' 1' r -' 7 , �7�'� �.� �.i�C�� <br /> '�'.f lUNf �OI.1Rk� <br /> JPK � �S"CSj ❑res��o FEE9 VALUATION FEE <br /> ''�'�. ��r ���^�5+ w' oCruv�ryCycRoun No of DwFLUNG uNirS 6UILDING S <br /> ���v M� �— M.UMBING <br /> ` :1 �� Bi G NG U!Sfpp�ES M�� OQ �O�D <br /> �4o Gp �,/ O / N� MECHANICAL <br /> r <br /> OTHER <br /> fIRE SPRINKLERS HEOUIRED ❑ YES NO STAiEBU1lD�NG SURCHARGE <br /> STATEENERGVSURCHARGE <br /> AVVI���.��ICI4�l:fB� o��N51:NECMEpBY •OPHfOp195U�NC[BV <br /> � vuauc woaKs <br /> � <br /> � <br /> l- � �u� /�,(j TOTAL <br /> \ <br /> PROPERTV OWNEFS ARE RESPONSIBLE FOR DETERMINING Al l <br />� PHOPERTV UNE LOCATIONS AND RELATED EASEMENTS <br />