Laserfiche WebLink
CONSTRUCTION <br />the E..ron•rl <br />CITY OF <br />everett PERMIT <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK • PLEASE PRINT <br />259.8810 <br />ClDEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL <br />MAIL AryOHESS CITY -V ^Ilv <br />OWNER . I E, V9 It- I <br />ARCHIfECIYj FSIGt iR MAIL ADOHESS <br />(iLNE HAL LUNIRAC1pR MAR nryDIJLGS <br />MAIL <br />q1Y 1�1' <br />CITY ZIP <br />eYeTnR <br />❑ PLUMBING <br />❑ SIGN <br />Yrr,orrr <br />HDIN. <br />„IInYI <br />I ILf NSL <br />I <br />to Nsr . <br />u <br />-Y')r <br />! <br />k Nsr <br />CUSS Or VIOPI' <br />❑ NEW [I ADDITION El ALTERATION ❑ REPAIR ElDLMOLITION ❑ WOODSY OVE/FRPL.INSERT BUILDING RELOCATION <br />vAu/ , nI VI(.•R. COST Or 11,111 •.SAL': PLUS LARORI <br />� of C-, (: <br />DES E WORK C - A <br />.riSIC 'I. _ <br />u�se Or�-BUILDH,G I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />-) ¢')E'`'�I 'll")-(�.1 PLICATION AND KNOW THE SAME TO BE 'TRUE AND CORRECT. ALL <br />7 VDE4CRIoiION Jr PPOj. PERtvIUIUWNRE LLOOR ATTACH FOUR COPIFSI PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TN PE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOJ_B1ow <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 CONTRACTOR AGENT DATE <br />PNOJECTADDRESS <br />e,M - 2 7"' AVI hl <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK A DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — HAINICP. V [ <br />SINK (SERVICE — BAR. ETC 1 <br />MECHANICAL <br />un7�TY VE <br />RIC — A/HNDLG UNITS — H.P. <br />REFRIGERATION UNITS — H P EA. <br />BOILERS — B.T U ,H P <br />GAS FIRED A C. UNITS — B T.U. <br />FORCED AIR SYSTEMS — B T.U. &CI M EA. <br />WALL HEATERS—B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EKHAUSTFAN <br />S>` <br />SUB TOTAL <br />r PEBMIT S tKRMIT <br />OTA <br />LF <br />EE TO TAL FEE S g <br />T I PLAN CHECK NUMBER I FEE I RECEIPT NO <br />RUNT SF tRACv 'REAR tiF.TBACv. SIDE SETBACK <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />OYES ❑NO <br />BUILDING <br />5 <br />T rPL UT CONST <br />VCCDI'nNCY GROUP <br />NO OF UWLLLING UNITS <br />PLUMBING <br />SIZE Or BI DO <br />NO nr STORIES <br />MAX OCC LEAD <br />MECHANICAL <br />OTHER <br />FIRE SPRINKLERS REQUIRED U YES D NO <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APE'11C-NON ACC BY <br />P1.f N:.CHECNEp DY AFPR rOR ISSUANCE BY PUBLICWORKS <br />TOTAL <br />ALL <br />PROPERTY PROPERTY LLIINE LOCATIONS AND NRELATED E EASEMENTS. <br />