Laserfiche WebLink
I <br />'�PLICATION FO1 <br />CITY OF OFF �I�.r. <br />CONSTRUCTION <br />everett <br />PERMIT <br />BUILDING DEPARTMENT <br />259-8810 <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION G BUILDING ❑ MECHANICAL <br />MAIL <br />El <br />❑ PLUMBING ❑ SIGN <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />LUATIOIJ OF WORK (COST OF MATERIALS PLUS LABOR, <br />1 L7YY1 OD <br />DESCRIBE WORK <br />bC 1 . rm-4:'n 1 /') , <br />usE of BI LmNc <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PI_ICATION AND KNOWTHE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING 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 CONTRACTOROR AUTHORIZED AGENT DATE <br />SI <br />APLICANTSCITY BUSINESS LICENSE NF�- <br />LEGAL DES(tiI P 110 N O F PROPE RTY(SHOWN B ELOW OR A I TACH F OU R COPI E S) <br />LOI—BLOCF__0F <br />PROJ CTADDREE�SSKKyyrr----- <br />If eVX�7ll <br />PLUMBINC, <br />MECHANICAL <br />NO. <br />TYPE OF 1'IXTURE. OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIFMENT <br />FEE <br />WATER CLOSET ,1 ^ LcT) <br />A/C — A/HNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ( WASH BACINI <br />BOILERS — B.T.U./H. P. <br />SHOLA cR <br />GAS FIRED A C. UNITS — D.T.U. <br />KI—TCi,E! HI 6 DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />— —} <br />' DISHWAS,i <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TM I <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />7RiNKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATERHEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />_— <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />f <br />f <br />f <br />SUBTOTAL <br />PERMIT S. <br />TOTAL FEE <br />FRONT SETBACK <br />RE/^SFTBAC <br />SIOL SEIBACK <br />PLAN CHECK NUMBER <br />'3,Fs I icin z3c- <br />FEE 13 <br />1 <br />RECENT NO ` <br />"T%gL JI <br />USEZONE <br />LOTAREA <br />VACAN ITE <br />ores <br />FEES <br />VALUATION <br />FEE <br />- <br />BUILDING <br />$ <br />i62 <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />E <br />PLUMBING <br />SIZE OF BLDG <br />ZOOS F <br />NO. OF STORIES <br />/ <br />MAX. OCC. LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED YES ❑ NO <br />OTHER <br />STATE BUILDING SURCHARGE <br />? <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />PLANSCHECKED dY <br />eL(i <br />APPR. FOR ISSUANCE BY <br />PUBLIC WORKS <br />TOTAL <br />1 <br />PROPERTY OWNEH5 AHE HE5PON51ULE FUH DETEHMININLJ ALL <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS <br />