Laserfiche WebLink
i--�PLICATION FOh' <br />. EYOp,e1R <br />evereR <br />CITY OF <br />i CITY <br />CONSTRUCTION <br />everett <br />PERMIT <br />BUILDING DEPARTMENT <br />259.8810 <br />TO BE COMPLETED IN INK- PLEASE PRINT\ <br />❑ DLNIOLITION ❑ COMBINATION <br />❑ BUILDING ❑ MECHANICAL <br />� PLUMBING <br />❑ SIGN <br />OWASR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />AR:HITECTOR DESIGNER <br />MAILADDRE55 CITY lzw <br />PHONE <br />GENERALCOWFIACTGR <br />MAILADDRESS CITY Z'P <br />PHONE <br />LICENSE <br />T MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE A <br />PLGMBINO CONTRACTOR MAIL ADDRESS 0. CITY ` ZIP <br />, 1oAae�ELo \ tv,� ` lsx• li)3� IS'Z' Rdi xi S�Attil, 1NA �181a� <br />PHONE <br />3b'► 3b�D S{yne <br />LICENSE• <br />n1T1 <br />/ CLASSOF WORN <br />l!• ❑ NEW ❑ ADDITION ❑ <br />ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION _ <br />VALUATIONOF wORKICOSi OF MATERI0.LSPWSLAPORI <br />DESCPJE WCAIK {. "GE, � gpgc1, <br />Y. ILA,-, 1P1 <br />USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />Rtst A NQ A �Jt <br />PLICATION AND KNOW THE SAMETO BETRUEAND CORRECT. ALL <br />PROVISIONSOF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LEGAL DESCRIPTION OF PROPENTYISNOWN BELOW OR ATTACH FOUR COPIESI <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPE- <br />LOT_BLOCK _.--OF <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />PROJECT ADDRESS / <br />A PPLICANFS CITY BUSINESS LICENSE NO <br />PLUMBING <br />CHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — AIHNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS—G.T.U.IH. P. <br />SHOWER <br />GAS FIRED A.C. UNITS — G.T.U. <br />KITCHEN SINK d DISP. <br />FORCED AIR SYSTEMS — 8 T.U. M EA. <br />DISHWASHER <br />WALL HEATERS —01 M <br />LAUNDRY TRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />UNINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />61 Isz <br />ROOF DRAINS — RAINLEAOERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />ao, <br />513 <br />METAL FIREPLACE & LHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />�— <br />EXHAUST FAN <br />SUBTOTAL <br />S ZO. <br />0o <br />SUB TOTAL <br />G <br />PERMIT <br />S <br />PERMIT <br />I <br />TOTAL FEE <br />S O. <br />W <br />TOTAL FEE <br />2 A <br />PLAN CHECK NUMBER <br />FEE (RECEIPT <br />NO. <br />REAR SETBACK SIDE <br />SET RACK <br />fRONT SETBACK <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />S <br />OYES ONO <br />BUILDING <br />TYPE OF COHST <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />��''yy•�� <br />O%O <br />PLUMBING <br />p.1J <br />. SIZE OF BLDG <br />NO OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />FIRE SPRINKLERS REQUIRED O YES O NO <br />STATE ENERGY SURCHARGE <br />APPUC.T'ON cC BY <br />PLANSCHECKEDBY <br />APPR. FOR ISSUANCE BY <br />PUBLICWORKS <br />i <br />�C <br />TOTAL <br />rmurcnT T vrmcna •.n� n�.+• ...�.--... —.. __. _..........._..__ <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />