Laserfiche WebLink
3PLICATION FOK' EYB,B„ <br />" CONSTRUCTION <br />'.7everett PERMIT e <br />BUILDING DEPARTMENT <br />269-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />Cl DEMOLITION ❑ COMBINATION IYRUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />I CSC %RuU( fAA/�it 2/Y02 e 01PAv 7f com,04VJ kA `?.r02d %%A/- 'pea, <br />ARCHITECT OO OFHIONER MAR AODRES9 CITY ZIP PHONE <br />ii�p/�l/ G(tJTorvt B�Lri / 9.� L7 %� i�0� surjr b' dtA771e Y6/3] A;2-,r0; r <br />GENERAL CONTRACTOR MAN ADORE SS GrY ZIP • ONE LICENSE <br />��Niar Cc/rz.Eu9 y� 9z9V /.?otl rui%c k JCnr7,6- PrlljJC2-roi5' ALAS CZIIAI <br />PHnNE LICENSE <br />F <br />PLUMBINGCONTRACTOR MAIL ADDRESS CITY EIP PHONE LICENSE <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ElWOODSTOVE/FRPL. INSERT ❑ BUILDING R <br />ALELOCATION <br />VALUATION OF WONM ICOST OF MATERIALS PLUS LABOPI Tizurr P'`"A/ �� 7F�� ITUALI G <br />/ A7 . i h. i� -T/i ... I, e <br />r VAC N FE. Z ti CL6EJL__ <br />USE OF BUILDING /^1 VV <br />O TB� <br />IJ ArA�o <br />I HEREBY CERTIFY THAT I HAVE nEAD AND EXAMINED THIS AP• <br />APLICATION AND KNOWTHESAMETO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LEGAL OEBCRIPUON PROPERLY IBMOWN BELOW OR ATTACH FOUR COPIFSI <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE - <br />LOT —BLOCK OF <br />- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHERS TE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PE ORMANCE OF CONSTRUCTION. <br />�1 <br />SIGNATURE CO FACTOR OR AUTHORIZED AGENT DATE <br />PROJECT ADDRESS <br />r*AftY BUSINESS LICE NS O <br />PLUMBING <br />MEC Al <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILETI <br />A/C - A/HNDLG UNITS - H P <br />BATHTUB <br />REFRIGERATION UNITS - HP EA <br />LAVATORY pL ISHBASINI <br />BOILERS -B.T U/H P. <br />SHOWER <br />GAD FIRED A C. UNITS - B T U <br />KITCHEN SINK 6 DISP <br />FORCED AIR SYSTEMS - B T U M EA <br />DISHWASHER <br />WALL HEATERS - BTU. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T.0 M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADEHS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC) <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />OAS PIPING <br />Ex 4AUST FAN <br />SUBTOTAL <br />f <br />BUS TOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTALFEE <br />f <br />TOTALFEE <br />REAR SETBACA <br />SIDE SETBACK <br />PLAN CHECKNUMBER <br />06 -lC/0�`� <br />FEE rL <br />g`� � <br />RECEIPT NO <br />97679 <br />FRONT SETBACA <br />` <br />USE ZONE <br />LOT AREA <br />VACANr ITE <br />FEES <br />VALUATION <br />FEE <br />S <br />/-' <br />,F <br />OYE �NO <br />/��/���`` <br />BUILDING <br />TYPE OF 1 <br />OCCUPANCY GDOUP <br />NO OF DWFLLINO UNITS <br />N <br />-/ <br />.1 <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAF OCC LOAD <br />MECHANICAL. <br />OTHER <br />STATE BUILDING SURCHARGE <br />FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO <br />STATE ENERGY SURCHAPGE <br />APPL ICATION ACC BY <br />PLANS C14ECKFU By <br />APPR FOR ISSUANCE BY <br />PUBLIC WORKS <br />j 1FIrl. <br />TOTAL <br />n.l.=U JIMn Al l <br />11 <br />T.nvrc , , _. <br />PROPERTY L IN_ LOCATIONS AND RELATED EASEMENTS. A <br />