Laserfiche WebLink
�'�1{ ''�.'..'7 <br />.�.PPLICATlON FO.. <br />`°.E'.,°`"° CONSTRUCTION <br />cin oF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ II�IECHANICAL ❑ PLUMBING <br />everetl <br />e <br />❑ SIGN <br />3SS�a3�1 <br />GENEMlG011IN�L1011 MAIIADORE55 CIIY 21P VBONE LICENSE� <br />MECIUNIGALCONiRRCIIJq M�ILAOORESS CIIY ZIP PIIONE LiC[NSE• <br />MML <br />2iV <br />❑ NEW ❑ ADDITION I� ALTERATION ❑ REPAIR ❑ pEMOLI710N ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING REIUCAfION <br />`/�1U�110N OF WOfiH �COSI O( IARIEIIIRlS PLIIS 1P00R1 <br />DESGliiUE WOf1K <br />C\,�,h <br />�oi_ <br />PLUMBING <br />WATER CLOSET (TOILET� <br />BATHTUB <br />LAVATORY�WASHBASIN� <br />SHOWER <br />KITCHEN SINK Q DISP. <br />CLOTHES WASIIER <br />URINAL <br />OflINKING FOUNTAIN <br />FLOOR DRAIN ' <br />- HNlrvl <br />— DAR. <br />SUBTOTAL <br />PEPMIT <br />TOTAL FEE <br />iRONiSEIOnCN RERfISETBACK <br />USEZONE LOTARE� <br />ttPEOFCON9T OCCUPRILYGNOi <br />, 512EOFOlDG NOOFSiOf11E5 <br />. FIRE SPqINKLEFiS REOl11RED O YES [ <br />APPIIGAiIONFCC OV PLANSCIIECNEDI <br />I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BETRUE AND CORREC7. ALL <br />PROVISIONS OF LAWSAND ORD�NANCESGOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED bVITH 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 IOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNATURE Of CONiRACiOR OR AUiHOPIZEO AGENT DATE <br />X 1�.��..` <br />UCENSE NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPME <br />A/C — A/HN�IG UNITS — H P. <br />REFRIGEFATION UNITS —H C. EA. <br />BOILERS — B.T.II./H P. <br />ame atienw <br />VACANT SIIE <br />OYES ONO <br />NO.OF �W[LLING UNIiS <br />MA%OLC LOAD <br />RPPP, FOR ISSI/ANLE BY <br />GAS FIRED A.C. UNITS — B.T.U. <br />FO�CE�AIii5Y5TEMS—B.T.U. MEA. <br />WALLHEATEFS-9.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVECOOLERS <br />CLOTNESOFYEFS <br />VENTILATION FAN <br />RANGEHOOD <br />WhTER HEATEfl : <br />WOODSTOVE <br />MET�L FIREPLACE d CHIMNEV <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />PlIIMIT <br />' TOTALFEE <br />PLnN CHECK NUMBER I FEE <br />OUILDING <br />PLUM8ING <br />MECNANICAI <br />OTHER <br />S7ATE BUIIDING SURCHARG <br />$TATEENERGVSURCHARGE <br />PUeLIC WOflKS <br />TOTAL <br />FEE <br />RECEIPT NQ. <br />VAIUATION FEE <br />$ <br />PROPEflN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCATIONS AND RELAIED EASEMENTS. <br />