Laserfiche WebLink
T :y <br />APPLICATION FQL'� tho evereR <br />CITY <br />crry of CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259.8810 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />�2nn�/ l r:c1; �rC N/CI C�c ls(GP/7�'0///4C . SFu1!/C y//S S'Lti< %2�3 <br />_. .. .,-..--- 1 nry � mP PHONE <br />CLASS OF WORK n <br />UrNEW ❑ ADDITION ❑ ALTERATION i REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION <br />i� 94 �f <br />171%, A, #C v re <br />1 C/v ELI- <br />USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />&7H/ L <br />PLICATION AND KNOW THE SAME TO BE TRU E AN D COR RECT. ALL <br />PROVISI DNS OF LAWS AN D ORDINANCES GOVE RNI NG TH IS TYPE <br />LEGAL O E SCRIPT ION OF PROP E RTYISNOWN D E LOW OD A I TACIT F OU R CON ESI <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED 11ERE- <br />LOT —BLOCK--oE <br />IN OR NOT. TH E GRANTI NG OF A PERM IT DOES NOT PRESUM E 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 />SONATURE OF CONTRACTOR on UTHOFHZ D AG N 'DATE <br />?4'f I,iL pp <br />- LdT -O tl <br />i <br />PROJECT ADDRESS <br />APPLICANTS CRY BUSINESS LICENSE NO <br />/640S, FeefTi <br />N�// cv <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-A/HNOLG UNITS -H.P. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASINI <br />BOILERS - B.T.U.IH.P. <br />SHOWER <br />GAS FIRED ABC. UNITS - B.T.U. <br />KITCHEN SINK B DISP <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />�- <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAFORATIVE COOLERS <br />URINAL <br />CLOTHE'; DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR GRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK ISERVICE — BAR. ETC) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />_ <br />HEAT PUMP <br />_ <br />GAS PIPING <br />EXHAUST FAN <br />SUBTOTAL <br />f <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT <br />_ <br />TOTALFEE <br />f <br />TOTALFEE <br />FRUIrt SETBACK <br />PLAN CHECK NUMBER <br />a, Is- Oo �d YQ <br />FEE� �C <br />J` J <br />RECEIPT NO. <br />9 -7 J'Ll <br />REAR SETBACK <br />SIDE SETBACK <br />USEZONE <br />LOTaReA <br />VACANW <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />DYES 3h <br />TYPE OP CON 1 <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNItS <br />PLUMBING <br />5 -�- <br />�- <br />SREOr BLOG <br />NO OF STORIES <br />MAX OCC. LOAD <br />- <br />5zMECHANICAL <br />OTHER 13q'S' SZGS <br />, <br />STATL' BUILDING SURCHARGE <br />"� <br />FIRE SPRINKLERS REQUIRED DYES ONO,_ <br />STATE ENERGY.SURCI IARGE <br />APPLICAIIONACC BY <br />PLMISCHECKEDDY <br />APPD. FOR IS5UANCE BY <br />PUBLIC WORKS <br />— <br />IJIA W) <br />/� <br />/ `� <br />TOTAL <br />--_ <br />YITV YCTTI N V TV I,Ln.] n�,r •.�,s• v...... .. _ _. _...... _...-... <br />PROPERTY LINE LOCA110NS AND RELATED EASEMENTS. <br />