Laserfiche WebLink
IRE EFBJEIBIR <br />-crry OF <br />everett <br />BUILDING DEPARTMENT <br />259-8745 <br />\,,tPPLICATION FO <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />1', e <br />evcrett <br />. <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />- Ml1 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />LICENSE• <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ ITUILDING RELOCATION <br />VALUATION OF WORK ICOIT OF MATERIALS PLUS LABORI <br />DESCRIBE WOR 1 ` <br />\ten S <br />USEOFBUILDING - -- - <br />Y�i E Am L <br />- - <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINE THIS AP- <br />PLICATIONANDKNOWTHESAMETCF[ TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINA.,:I,c S GOVERNI NGTH IS TYPE <br />OF WORK WILL BE COMPLETED WITH NHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OFe <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN EOF CONTRACTOR OR THORIZED AGENT DATE <br />X �a - <br />LEGAL DESCRIPTION OF PROPERTYISHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT— BLOCK-0 <br />PIOJECTAODRESS <br />APPLICANTS CITY BUSINESS LICENSE NU I III <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET TOILE <br />AIR COND. UNITS—H.P. EA. <br />BATHTUB <br />I REFRIGERATION UNITS—H.P. EA <br />LAVATORY WASH BASIN <br />BOILERS—H.P. EA <br />SHOWER <br />GAS FIRED AC. UNITS —TONNAGE EA <br />KITCHEN SINK& DISP. <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS—B.T,U. M_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />' <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— CF,M. <br />-- <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE S CHIMNEY <br />" - <br />SINK SERVICE —BAR ETC. <br />WOODSTOVE/ FIREPLACE INSERT <br />r•; <br />BUS TOTAL <br />SUBTOTAL I <br />PERMIT I <br />PERMIT I <br />TOTALFEE I <br />TOTALFEE I <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />FRONT SETBACK REAR SETBACK SIDE SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />DYES ONO <br />FLEE <br />VALUATION <br />FEE <br />TYPE Of CONST. <br />OCCUPANCYGROUP <br />NO. OF OWELLING UNITS <br />BUILDING <br />S <br />SIZE Of SLDO <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE SPRINKLERS REQUIRED ❑ YES 0 N <br />MECHANICAL <br />OTHER <br />PENALTY <br />APPLICATION ACC. BY <br />• � <br />�'SIII/I ��/' <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />TOTAL <br />