Laserfiche WebLink
�, �`� <br /> ' APPLICATIOI� r�� everett <br /> fA�EwryMn CONSTRUCTION <br /> CITY OF � <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br /> BUILDING DEPT. <br /> 259-8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEN MAILNDORESS CITY ZIP . PHONE <br /> mikc srn.�ORc �f8/ - y7�// I <br /> ARCNITECTORUESI�NER MMLAD�RE55 C1TY 21P PHONE �, <br /> ��hp/�<'SS� � �c-5�5,� � 1.�.�9 �eckSe.J �v!'..e7E 5'A.."��.3 .3�3-"- 330�� � <br /> GENENALCONTRnCTOR , ' MRILADDRESS QTY ZIP PHOiIE LICENSE+ , <br /> ra „.r3 Ca v C �ST iGy2/ �NU D/' N ..J. /j�-L�..�ST'J fSa�3 LS.�-�Fa3� �"n•.�r.l �ciey��A <br /> MEGHANICAI CONTfl�CTOq � M�II A�DRESS CITY ZIP PHONE LICENSE• <br /> E•r� H �N ' sldTc S4r�T ,.,�TaC •�y/� Ne rs F•N�-� r! y'Y.2ob >a2-3ir <br /> PLUMBI CONTRRGTOR MAILADUHESS . Cltt ZIV PMONE LIGENSE• <br /> �-� ,(' PC< 6 .,.�, Y'710 i63•-v PL. N f A�Ci,,,qT�.J SSJ1.3 N,jS-. us•�!� _ ��� <br /> CrU-��SS OF WORK I <br /> 17 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOL�TION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION �I <br /> V�W�TION OF�JWORK�fAST OF MFTERIALS PWS L�BORI I <br /> � d i s�i� �O � <br /> � _ <br /> OESCRIBE WORN , <br /> SiN < < ri�-.. � L .PrS, �e.✓c � /G,3 � � f.'��� (lr. i- <br /> use oF em�ou+a . <br /> e3 �c^ .� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> . in� ,LP � Sir+�+ iC R PLICATIONANOKNOWTHESAMETOBETRUF.ANDCORRECT.ALL <br /> lE0AL0E5CRIPTIONOFPROPERTYISHOWNBELOWOFARRCMFOIIPCOPIES7 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> � �r�T a � �, t5��w��p� OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- <br /> �or_�e�oc�—oF IN OR NOT.THE GRANT�NG 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 /> SIGNATURE OF CONiRACTOR O AUiMORIZED AGENT DATE �' �-�' S7 <br /> � � <br /> ir�-v�_ � <br /> PROJECTADDRESS qPPLIC CITYBUSINESSLIGENSENO, , <br /> PLUMBIN� MECXANICAL �' <br /> NO. TVPE OF FI%TURE FEE NO. TYPE OF E�UIPMENT FEE I <br /> Z WATERCLOSETITOILE AIRCOND. UNITS–H.P.EA I <br /> 2. BATHTUB REFRIGEPATION UNITS–H.P.EA. <br /> Z LAVATORV�WASH BASIN� I BOILERS–H.P.EA. <br /> � SHOWER – GAS FIRED AC.UNITS–iONNAGE EA <br /> KITCHEN SINKB DISP. FORCED AIR SVSTEMS–B.T.U. M EA. . <br /> DISHWPSHER WALL HEATERS–B.T.U. M <br /> LAUN�RYTRAY UNITHEATERS–B.T.U. M <br /> I GLOTHES WASHER EVAPORATIVECOOLERS i' <br /> WATER HEATER CIOTHES DRVERu b '. <br /> URINAL VENTI�ATION FAN �I <br /> DRINKING FOUNTAIN "- RANGE HOOD � <br /> FLOOR DMIN AIR HAN�LWG UNI7– GF.M. ' <br /> WCUUM BREAKERS STOVE ' <br /> ROOF DRAINS–RAINLEA�ERS METAL PIREPLACE F CMIMNEY I <br /> SINK SERVICE–BAR,ETC. I WOODSTOVE/FIREPLACEINSEHT <br /> SUBTOTAL SUBT0TIIL S <br /> PEHMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> FRONTSETB�CN RE�RSFTBACK SIDESETBACK PLFNCNE KNUMBER PUNCNECKFEE <br /> µD �O � /�I��IQ��O FEE� RFCEIPTNOq�agO <br /> �u <br /> USEZONE IDTAREA VnCANT5ITE FEES VALUATION �� <br /> J OYES ONO � � <br /> ttPEOFCONS OCCUPANCYGROUP NQOFDWELLINGUNITS L�/'� . <br /> �� '� / BUILDINC� 5�8Jw �/ <br /> 512E OF BLOG. NO.OF StORIES MAX OCQ lOnO <br /> I�7 f G O �� PLUM9ING � <br /> MECHANICAL I <br /> FIFE SPRINKLERS REQUIRED ❑YES l�NO — �,.�� G, � I <br /> v <br /> . alfeRtriV . <br /> ` APP4CFTi0N ACC.BY PLANS GNECNEU�Y APP�-FOR ISSUANLE BY <br /> :,.�. —L}; TOTAL <br /> `7'� " � _G, <br /> 1..' � <br /> ,._' �/1/ �:�.. <br /> - I, <br /> I <br /> 4 <br />