4316 S 3RD AVE 2018-01-02 MF Import

A.'PLICATION FOR--` CITE"'°"'" CITY OF CONSTRUCTION everett PERMIT TO BE COMPLETED IN BLACK INK— PLEASE PRINT BUILDING DEPT. 259-8745 fl COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSER MECHANICAL CONTRACTOR MAIL ADDRE55 CITY TIP PHONE LICENSE PLUMBING CONt PACtOR MAIL ADDRE55 CRY ZIP PHONE LICENSE• CLASS NEW WORK ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION Ix WOODSTOVE/FRPL. INSERT ❑ BUILDING RELOCATION DESCRIBE WORK ` Y- -#�h�:�i-�� LLJouo i�Lc.rh � UTiE Or BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE Or PROPEDIYISIIOWN BELOWORATTAG11rOURDOPIESI LEGAL DESCRIPTION OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO LOT— BLOCK —Or TO VIOLATE OR CANCEL THE PROVISIONS OF GIVE AUTHORITY ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF CONIRACIOR ORAU1110RIZED AGENT DATE X APPLICANTS CITY BUSINESS LICENSE NO PROJECT ADDRESS J MECHANICAL _ — PLUMBING TYPE OF FIXTURE FEE TYPE OF EQUIPMENT Far NO. COND.UNITS—H. P. EA. WATER CLOSET (TOILET) TION UNITS—H.P. EABATHTUBLAVATORY H. P. EA. (WASH BASIN Ull A.C. UNISSI/OWER IR SYSTEMDISHWAS14ER KITCHEN SINK A DISP. TERS—B.T.U. M ERS—I U. M — LAUNDRY TRA\' EVAPORATIVE COOLERS CLOTHES WASHER CLOTHES DRYERS _WATER HEATER __ VENTILATION FAN WTINAI RANGE HOOD _ — DRINKING FOUNTAIN _ AIR NIT— C.F.M. HANDLING U — — FLOOR DRAIN STOVE VACUUM BREAKERS _ _ FIREPLACE CHIMNEY _ ROOF DRAINS—RAINLBADERS _METAL WOODSTOVE/FIREPLACE INSERT SINK SERVICE —BAR. ETC. SUBTOTAL f SUB TOTAL _ PERMIT f PERMIT f _ TOTAL FEE f TOTAL FEE THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL