Laserfiche WebLink
(hC Ereiqrecn <br />CITY OF <br />everett <br />❑TYNAII ]59BE65 <br />EVEflETt, 1Vi51114Li0'i <br />9P.111 <br />�EPr a<<o•.:�.,�.,�r. gUILDING <br />etv:iavuv+r <br />CONSTRUCTION <br />PERMIT <br />MECHAf�ICAL PLUMBING <br />OWNER MAIL ADpRESS 21P PHONE <br />�iT� , • <br />Aq MITEGT Ofl pE51GHER MAiL ADDRE55 PHONE L�CENSE NO. ��j:i.rri <br />GCNERAL CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br />.���� r�lii.�J�� <br />M1:CHAfJICALCONTFACTOR MAILADDRE55 PHONE LICENSENO. <br />PLI�MBING CONTFACTOR MAIL ADORE55 PMONE LICENSE NO. � <br />W <br />m <br />PF.RMIT CLASS OF WORK � <br />z <br />��UILOING �PWM�ING �MECHANICAL F- <br />❑NEW �AOf�ITION ❑ALTERATION ❑REPAIR <br />� <br />VALUATION OF WORK � <br />5�.�-�.�. ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POO� a <br />DESCRIBE WORK <br />� a�r tti �.�r_�� c� a� 2 2 I 6 <br />PqOPOSED VSE MECHANICAL <br />TYPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br />�[GA� DESCFIPTION OF PFOPERTY (SHOW AELOW OF ATTACH GAS <br />FOUR CoF ,PIE51 •e <br />Loi `� oLocK '°� oFr��' �� �e ��a =� !� NO. TV'E OF EUl11PMEN7 FEE <br />AIR COND. UNITS-Ii.P. EA. 5 I <br />_�� �� REFRIGFRATION VNITS-H.P. EA. , <br />BOILERS-H.P.EA. I <br />GAS FIRED A.C. UNITS–TONNAGE EA. <br />FORCED AIR SYSTEMS–B.T.U. M EA. I <br />JOO A�DRESS WALL HEATERS–B.T.U. h' �— <br />�IF'N� ��_{Q NIT HEATERS–�.T.U. M I <br />EVAPORATNE COOLEPS <br />PLUMBING CLOTHES DRVERS � <br />VENTILATION FAN �— <br />RANGEHOOD I <br />NO. TVPE OF FIXTURE OR ITEM FEE <br />AIR HANDLIf�G UNIT– C.F.M. <br />WATERCLOSETI701L[T) g INCINERATOR I <br />� BATHTUB T— <br />LAVATORYIWASHBASINI � <br />SHOWER <br />KITCHEN SINK & DISG. SUB TOTAL 5 <br />DISHWASHER PERMIT 5 T— <br />LAUNDRY TRAV TOTAL FEE S I <br />CLOTHESlNA51lEH THIS PEFM1".IT 6ECOMES NULL AND VDID IF WOftK Oli CONSTRVC- <br />�N�1TER HEATER TION AUTHORIZE� IS NOT COMMENCED VJITHIN 120 DAYS, OFi IF <br />URINAL CONSTFUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />DRINKING FOUNTAIN PEflIOD Of- 120 �AYS !�T ANY TIME AFTER WORK IS COMMENCED. <br />FLOOR–SINK OR DFiAIN I 11EREBY CERTIFY THAT 1 HAVE flEAD AND EXAMINED THIS AP� <br />VACUUM BREAKERS PLICATION ANO KNOW THE SAME TO BE TRUE AN� CORRECT. ALL <br />— PROVISIOfvS OF LAWS AND O(iDW�1NCES GOVEPNING THIS TYPE <br />ROOF �RAIN.–RAINIEADERS__ pF WORK WILL DE COMPLIED WITH WHETHER SPECIFIEO HEREIN <br />SINK (SERVICE–BAR, ETC.) OR NOT, THE GRANTING OF A PERMIT DOFS NOT ?RESUME TO <br />— GIVE AVTHOFITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OH LOCAL LAW REGULATING CONSTfiUCTION <br />OR TIiF PERFOflMANCE OF CONSTRUCTION. <br />SUB TOTAL <br />PERMIT 5 —� <br />TOTAL FEE 5 <br />X �.+7 <br />SIGNATUREOf-CONTRACTORORAUTH.AGENT DATE <br />SIDE VARD SET[3ACK STFEET SEl"�ACK R@AR YARDSETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE flECE1PT NO. <br />USE20NE LOTAREA VACANTSITE <br />❑VES ❑NO FEES VALUATION FEE <br />TVPE OF CONST. OCCUPANCV GROUP NO.OF �WELLING T— <br />UNITS I <br />SIZE OF BLDG. NO.OF STORIES MAX.00C. LOAD DUILDING $'J���,f� � <br />�i� ��� <br />PLUM[11NG � <br />fIRE 20NE BASEMENT FIRESPRINKLERS 1 <br />R QVESED ❑NO MECHANICAL j <br />SPECIAL CONDITIONS: OTHER � <br />PENELTY SEC.3031a) I <br />TOTAL � <br />.�i� Q�ti <br />PERMIT VALIDATION <br />WHEN PROPERLV VqLIDATED (IN THIS SPACEI THIS IS VOUF PERMlT <br />qi'PIILATIONACtEPTEOBV: PLANSCHELREOOY' APPPOVl�FO(165WVlCEUY�. <br />P.t <br />n � <br />