Laserfiche WebLink
hPPLICATION FOL-' <br />CITY of <br />CATS CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION O COMBINATION BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />Alluu IECT On DI SIGNOR MAIL ADDRESS Cm ZIP PHONE <br />5/iltiTtlE"L <br />IH. NEPAL CONInACIOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MiGUNICAL CONTIMCTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBRJGCONIRACTOR MAIL ADDRESS CITY ZIP PHONE LIFE NSL <br />NEW ❑ ADDITION ❑ ALTERATION Cl REPAIR ❑ DEMOLITION Cl WOODSTOVE/FRPL. INSERT ❑ BUILDING RELOCATION <br />I-L I;' -,A I, / _ Pi t'F +- <,.,.,,_ "AA PP- Na 1sT O,V Z64VAl�,- Dot K <br />USE or BUR DING <br />'7 <br />IIZC L -' <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PL (CATION A ND KNOW TH E SAME TO BE TF U E AND CORRECT, ALL <br />PROVI SIONS OF LAWS AND O RD I NANCE S GOVE RN I NG TH IS T YPE <br />OF WORK WILL BE COMPLETED WITII WHETHER SPECIFIED HERE- <br />IN OR NOT. THE G RANTING OF A PE R M I T DOES NOT PRESU M E 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 />SIGNATUR OF CO Ni FACTOR ORAL) EqR IZED AGENT DATE <br />X 1Ej <br />LEGAL DESCRIPTION OF PROPEnTYESHOWN BELOWON A17ACH FOURCOPILSI <br />LOI_BLOCK OF <br />PROJECT ADDRESS <br />�70/ bi <br />APPLICA rS CIiY BUSINESS LICCNSE <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FI%TURF <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS-H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS-H P. EA <br />_ <br />LAVATORY(WASH BASIN) <br />BOILERS-H.P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS -TONNAGE EA. <br />_ <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS-B.T.U. M EA <br />DISHWASHER <br />WALL HEATERS -BTU. _ M <br />_ <br />LAUNDRY TRAY <br />_ <br />UNIT HEATERS-B T. U. M <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />I <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- OF.M. <br />_ <br />_- <br />VACUUM BREAKERS <br />STOVE <br />_ <br />_ <br />ROOF DRAINS-RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />_ <br />SINK ISERVICE-BAR. ETC <br />WOODSTOVE/FIREPLACE INSERT <br />SUBTOTAL <br />SUBTOTAL S <br />_ <br />PERMIT A <br />PERMIT f <br />_ <br />TOTAL FEE III <br />TOTAL FEE f <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />ALAN SETBACK SIDE SETBACK PLAN CHECK NUMBER PUN CHECK FEE <br />FEE RECEIPT NO <br />LOT AREA VACANT SGE <br />FEES VALUATION FEE <br />DYES ONO <br />OCCUPANCY GROUP NO OF DWELLING UNITS <br />BUILDING <br />OF BLDG NO OF STODIE$ MA%. OLC. LOAD <br />PLUMBING <br />MECHANICAL <br />E SPRINKLERS REOUIRED ❑ YES ❑ NO <br />OTHER <br />PENALTY <br />]CATION ACC BY PLANSCHECKED BY APPR FRRRRISSLANCE BY <br />/ Y. L TOTAL <br />