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A LIGATION FOR EYEFEN <br />Cs"OF "" CONSTRUCTION <br />` un of <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />owN� TLlnv nP PnuHrsi-.s -LNc 2��0` Nuay �T Edm�s9�oZo-7)�$88 <br />ARCHITECT OR Ot SIGNIG MMI ADDRESS CIM1 llP PHONE <br />PNONF <br />00JA TF-1 <br />MECH ANICAL CON in F C �TOR/ MMI ADDRESS CITY III PHONE LICENSE A <br />O�IL� PWMBINR CONTRAC IOn MAIL ADDRESS CITY ZIP PItONF LICENSE 1 <br />:LASS❑ NEW Of ORK❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEJFRPL. INSERT Cl BUILDING RELOCATION <br />I ....... —n wnnu!'.n,, nr MArtnIALS Pt OS I AHnm <br />USE OF BUILDING <br />- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <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 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />R AA UUPMRIZE.O,AeGEENT DATE J((J <br />SIGNATURE OF CON TRACTOR_OA.Nl <br />V� <br />API91I ANN I' CITY IIUV L SS UCIr <br />LEGALOEs I IOIONOFPnoPEmYISHOWNBELoWOHATIAun UMn CGIIt SI <br />LOT_BLOCP_OF <br />PROJECT ADDRESS L <br />�g 15 c U Ca�1Rn�,t �l <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - AOINOLG UNITS - F: P <br />BATHTUB <br />nEFRIGEPATION UNITS -MP EA <br />LAVATORY I W ASH B 4SIN1 <br />BOILERS - B T U M P <br />SHOWER <br />GAS FIRED A C UNITS - B T U <br />KITCHEN SINK A DISP <br />FORCED Ain SYSTEMS - B T U M EA <br />DISHWASHER <br />WALL HEATERS - BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION 1 AN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENT'ERS <br />WATEFIHEATER <br />ROOF DRAINS - RAIAILEADERi <br />WOOD STOVE <br />SINK (SERVICE - BAR ETC) <br />METAL FIREPLACE A CHIMNEY <br />FInEPLACE INSERT <br />HEAT PUMP _ <br />GAS PIPING <br />EXHAUST FAN <br />EUB TDTAL t <br />CUB TOTA'. <br />PERMIT f <br />PERMIT <br />TOTALFEE ! <br />TOTAL FEE <br />- <br />In. AN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />FRONT SETBACv <br />RUR 9E TRACK <br />SIDE Sr OTACI <br />USE ZONE <br />LOI P11IA <br />VACANT sm <br />❑YES FIND <br />FEES <br />VALUATION <br />FEE <br />-- <br />BUILDING <br />S <br />TYPE OF CONST <br />OCCUPANCY GnOUP <br />140 OI OWLLI ING UNITS <br />PLUMBING <br />SIZE OF BLUU <br />NO O• SIOmFS <br />MAX OCC LOAD <br />MECHANICAL <br />OTHER <br />FIRE SPRINKLERS REQUIRED Ll YES O NO _ <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICAIIGNACI; 01 <br />PUNS CHECKED RT <br />APPR FOR ISSUANCE BY <br />PUBLIC WORKS <br />TOTAL <br />mnumwl A. mR nFTFRMINING ALL <br />P..v.E..��................_..__ - <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />