Laserfiche WebLink
�PLICATION fOf� �,�,�„ <br /> '"'E~'°'"" CONSTRUCTION e <br /> cm oc <br /> everett PERMIT <br /> BUIIDING DEPARTMENT TO BE CUMPLETED IN INK- PLEASE PRINT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> M AOOAE55 CITV 21P PHONE <br /> OWNER L <br /> ()L��� ci,,�� F�., l�</r r�iu�J�i ,. �u - ��k G5° �'An.,�gr 94vL.� �Jt�-,27/2 <br /> �RCMiTECi OR 0�SIGNER MnIL R�DRE55 C TV Z�� PNONC <br /> GEhEA�LCONIRAL109 <br /> Mall apORE55 C�n' 2iP o��ONE ULENSE• <br /> • <br /> MECN�NIUICONTR�CTOfl <br /> M�IL�OORE55 C�Iv LP VNON[ �iCtNSE• <br /> M�R AU�AE55 Cltt LIP P��ONE '.ENSf• <br /> PLUMBIN�GONTRRGIOR . .� ��`/A <br /> � � �¢�c �. .vv �. U u (v"-`/L37 ic <br /> GUSS OF WORN <br /> �NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEPT BUILDING RELOCATION_ <br /> V�IWTIONOfWORhICOSTO�MRTERIAL5PLU5lAA0F1 � <br /> OESCP�BE WORM _ 1 / � • <br /> t/ t ! ` ` ' ` lrcil w. //! <br /> USE(lF OUILOiNG I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP• <br /> � PUCATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br /> iec��oescnivrior+ovraoren*visnowr+eeiowopni�nc��ouacoriesi � PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br /> OF WOf1K WILL BE COMPLETED WITH WHETHERSPECIFIED HERE- <br /> iot_B�o�K—oF IN OR NOT.THE GRANTINCa OF A PERMIT DOES NOT PRESUME 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 /> SIGNATURE Of GONiRACTGR OR AUTMOR12ED AGENT O�TE <br /> 17�7 X ._�_ 0 4 . <br /> � �� �ppL pNT5C1iYBU51NE$SL�CFNS NO <br /> PROJEGT�ODRE55 <br /> MECMANICAL <br /> PLUMBING �E <br /> � NO. TYVE OF flXTURE OR ITEM <br /> FEE NO. TIPE OF EOUIVMENT <br /> qiC—AMNDLG UNITS—H P. <br /> W�TER CLOSET ITOILET� <br /> REFRIGERATION UNITS—M.P.EA. <br /> BATMTUB <br /> BOILEPS—B.T U/H P <br /> LAVATORVIWASM BASINI <br /> GAS FIRED A�C.UNITS—8 T.U. <br /> SHOWER <br /> FORCE�A�N SVSTEMS—B T.U. M EA. <br /> NITCHEN SINK 8 DISP. <br /> WALLNEATERS—B.T.U. M <br /> OISFIW�SMER <br /> UNIT HEATERS—BS.U. M <br /> UUNOAV TRAV <br /> EVAPORATIVE COOLEAS <br /> CLOTHES WASHER CLOTHES ORVERS <br /> URINAL <br /> VENTIIATION FAN <br /> DRINKING FOUNTAIN qpNGE HOUD <br /> FLOOR DRAIN <br /> WATER HEA7ER <br /> BACKFIOW PREVENTERS WOODSTOVE <br /> ROOF DRIIINS—RAINLEA�ERS � ME7p�FIREPUCE 8 CHIMNEY <br /> SINK ISERVICE—BnR.ETGI _ FIREPLACE INSERT <br /> 2 � � rc r <br /> HEAT PUMP <br /> 2 GAS PIPING <br /> � E%MAUSTFAN <br /> � —! • <br /> SU!TOTAL <br /> SUs TOTAL = pEpMIT <br /> PERMR s <br /> f � TOT�LFE[ <br /> TOTALFEE qECEIPTNO. <br /> tRONi5E18ACM RE�R$E1B�CN SIDE SETB�CK <br /> PLAN CMECK NUMBER FEE <br /> ior�ne� FEES VALUATON �E <br /> � USE 20NE V�UNT S�TL <br /> ❑rEs �NO BUILDING 5 <br /> TYPEOFLONSi OCCIIPPNGYGROUP NO.OFDWELLINGUNITS '/,` �_ <br /> PLUMBING �'�J <br /> SRE OF OI�G NO OF STORIES MA% OCC LOAD MECHANICAL , <br /> �. <br /> OTHER <br /> 1 <br /> FIA�d SPRINKIERS REOUIiiED ❑ YES ❑ NO STATE BUILDING SURCHARGE <br /> STATEENERGYSURCHARGE <br /> qVPLICAIIONALCBV PLANSCHECNEOBY APPRFORISSUANCEBY pUBLICWORKS <br /> TOTAL �� ^ <br /> PROPERTY IOINE LOCATONS ANDNRELATED EASEMENTIgING ALL <br />