Laserfiche WebLink
^PPLICATION LOB: <br />the °"" <br />Of <br />OF <br />CONSTRUCTION <br />CITY <br />CI" <br />everett <br />PERMIT <br />BUILDING DEPARTMENT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />259-8810 <br />� <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />ZIP <br />.24LUMBING <br />evereM <br />e� <br />❑ SIGN <br />PLUMBING ,I niA it C A n / Y///!1 lJi[iN1 /iE2l �� Tf � � Yi":1'�1EP, AY/UI nZG9�9- (?9.Za-? -1. 5�,7 � A 10 <br />OLA55 r wu�K <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />VALUAIION OF WORK ICOST OF -Al ERIALS PLUS LABORI <br />F�iR1wI! <br />r <br />x <br />USE OF BUILDING <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 />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />DESCRIP11 NOF PROPERTY) HOWN BELOW OR ATTACH FOUR COPIES) <br />LEGAL <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT— BLOCK_OF <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 CONTRACTOR OR AU ORIZED AGENT DATE // � —11-7 <br />/OjF <br />S <br />/L <br />APPLICANT$ CITY BUSINESS LICEWSE NO <br />PROJECT ADDRESS <br />5>: ee <br />� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS —H.P. <br />REFRIGERATION UNITS — H P. EA. <br />BATHTUB <br />LAVATORY (WASH BASINI <br />BOILERS—B.T.U./H.P. <br />— <br />GAS FIRED A.C. UNITS—B.T.U. <br />SHOWER <br />FORCED AIR SYSTEMS — 8 T.U. M EA. <br />KITCHEN SINK 6 DISP. <br />WALL HEATERS—B.T.U. M <br />DISHWASHER <br />--- <br />UNIT HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />URINAL <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />PERMIT <br />f <br />f <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />f <br />TOTAL FEE <br />' <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />I PONT SETBACK <br />REAR SEI8ACK <br />SIDE SETBACK <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />5 <br />OYES ONO <br />BUILDING <br />TYPE OF CONSi <br />OCCUVNCY GROUP <br />NO Of pWFLLMG UNITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX. OCO LOAD <br />MECHANICAL <br />LDING SURCHARGEERGY <br />FIRE SPRINKLERS REQUIRED ❑ YES O NO <br />ESTATE <br />SURCHARGEAPPLICATIO <br />Y <br />PLANSC'IECKED BY <br />APPR FOR ISSUANCE BY <br />ORKS <br />TOTAL <br />n.lrouI.IMF. At I <br />_- <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />