Laserfiche WebLink
•p�4,� e-, <br />Ai��PLICATION FOR-::`�- <br />IM Ev�rymn C O N ST R U CT 1 O N <br />cirv oF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION D BUILDING ❑ MECHANICAL <br />M�IL <br />�1 <br />❑ PLUMBING <br />-f'F-°"�Ma(f <br />,. <br />everen <br />e <br />LICENSE • <br />N <br />MEGN�NIGLCONiR�GIOfl � - MML�O�RLSS cn♦ lir . r110NE LIGEMSE��j� <br />PLUMBINOCONiP�CfOR MAILADDNE55 GIIY 21P PIIONE UCENSE� <br />OF WORR <br />NEW ❑ ADDITION ❑ ALTERATION ❑ qEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />PNOJEGT�ODNESS <br />/ ��r`� � <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET ITOILET� <br />BATMTUB <br />UVATONY IWASM BASIN� <br />SMOWER <br />KITCHEN SINK 6 OISP. <br />IAUNDPYTRAV <br />CLOTNES W�SHER <br />URINAI <br />DRINNING FOUNTAIN <br />FLOOR DRAIN ' <br />BACKFLOW PREVENTE <br />ROOF ORAINS — RAINI <br />SINK ISERVICE — BAR. <br />SEfBSGK <br />USE ZONE <br />G� <br />1YPE OF CONST <br />SUSTOTAI <br />PERMIT <br />TOTAL FEF <br />ME�R SEiBACR <br />LOiAREA <br />GROUP <br />/� <br />SIDE SETBI�CN <br />0 <br />I HEREBY CERTIFY THAT I HAVE READ��IG�(J EXAI�AINE��YF�IS�XP• <br />PLICATION AND KNOW THE SAME TO BETRUEAND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGI HISTYPE <br />OF WORK WILL BE COMPLETED W�TH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER�S TATEORLOCALLAWREGULATINGCONSTRUCTION <br />OR THEpEFjFORMANCE OF CONSTRUCTION. . <br />SIGNATU��E OF�;ON7RACj/QR OR Ay.[HOR12Ej� AGENT OnTE <br />X � <br />erpu.e�r.- Itreu5wE55 <br />MECMANICAL <br />FEE NO. TYPE <br />V�L�NTSIIE <br />OYES ONO <br />NO.(lF DWELlINO <br />�CG BY IPUNSL'MEGREOBY I�PPN f01i1� <br />A/C — A/MNOLG UNITS — N.P. <br />REFRIGEFIITION UNITS — N.P. EA. <br />BOILERS — B.T.U.IH P. <br />GAS FIRED A�C. UNITS — A.T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALLMEATERS—B.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESOHVERS <br />VENTILATION FAN <br />RANGEMOOD <br />WATEPMEATER <br />WOOOSTOVE ` <br />METAL FIREPIACE d LNIMNEV <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />� SUlTOTAL <br />VLRMIT <br />TOTALFEE <br />PIAN CHECK Nl1M8ER � FEE � RECEIPT NO. <br />FEES VALUATION FEE <br />BUILDING S <br />PLUMBING <br />A7ECMANICAL <br />OTHER <br />S7ATE BUILDING SURCHARGE <br />STA7EENERGYSURCMARGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERTY OWNERS ARE RESPONSIBI.E FOR OETERMININO ALL <br />PROPERTV LINE LOCATIONSANO RELA�fED EASEMENTS. <br />