Laserfiche WebLink
•-APPLICATION FGA <br />IA. EYerOr«.'I <br />CITY OF <br />CONSTRUCTION <br />everenl <br />everett <br />PERMIT <br />BUILDING DEPARTMENT <br />259-8745 <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />JWI R <br />{ Ef.til�t <br />'"AIMS <br />wTorl <br />CITY ?IF <br />182p-5=2 T, Ex4zrT g(p, 1 <br />PI.ONE <br />'L51-moo <br />IRC111TECT <br />QOI<.E 6.E B 32'!' <br />MAIL ADDRESS C <br />ETwoREFuC�IiV E r �r]8IP ? 01 <br />PHONE <br />Zs� • 3 ��1 <br />9ENERAL CONTRACTOR <br />�CWLAAIU4�1' <br />MAIL ADDRESS <br />INC. 3� C}(ES11 <br />CITY ZIP <br />PHONE <br />'j���� <br />11 ENSE <br />�Ug820� <br />;Wi o <br />AECHANICAL CONTRACTOR <br />Uµ Kow 0 <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE• <br />PLUMBING CONTRACTOR NKo�,�N <br />U <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />'!CENSE- <br />4l Ass of WORAKp� <br />❑ NEW ADDITION D <br />Cl El ❑ <br />yE� ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPLANSERT El BUILDING <br />RELOCATION <br />iALLATICN )r WCRKICC'3] Or MAD'M 45 PLUS LABOR, <br />1 <br />DESCRIBE WORK <br />R�01T 101.1J d-._ <br />- ON S1 <br />" L — I I►AAdG <br />RSE OF BUILDING <br />i�... _.., - E _ y <br />h 1 l VKµI� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOWTHE SAME TO BE TRUE.AND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL LE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHOR, Y TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHSA ST TE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THEERF MANCE OF CONSTRUCTION. / <br />SIGNAT EOf TR /� UTII RIZED AGENT DATE `V� <br />LEGAL DESCRIPTION OF I.IOPERTYISI4OWN BELOW OR ATTACH FOUR COPIES) <br />I.OT_BLOCK __OF- <br />^., <br />L U -' -s I. c <br />ryL <br />U{� LAo I) C• _ <br />�Aw1 <br />P OJECT AUORESS <br />1620.3'LN� �TIzcE <br />AFPLICAN SCITY BUSINESS LICENSE NO <br />Dl 1 7 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />_NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSIET(TOILET) <br />_ <br />_AIR CONE. UNITS—H.P, EA. <br />BATHTUB <br />REFRIGERATION UNITS—H. P. EA. <br />LAVATORY (WASH BASIN)BOILERS—.[P. <br />EA. <br />SHOWER <br />GAS FIRED A.G. UNITS —TONNAGE EA <br />KITCHEN SINK d DISP. / <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEA7ERS-8. T.U. M <br />CLOTHES WASH <br />EVAPORATIVE COOLERS <br />WATER IT <br />CLOTHES DRYERS <br />URINAL _ <br />VENTILATION FAN FI <br />DRINKINd FOUNTAIN <br />RAIJGE HOOD <br />FLOO DRAIN <br />AIR HANDLING UNIL C.F.M. <br />VA UM BREAKERS <br />STOVE T— <br />OF DRAINS—RAINLEADERS <br />METAL FIREPLACE d <br />_ <br />MNK(SERVICE—BAR, ETC) <br />WOODSTOVE/FIREPLACE INSERT <br />SUBTOTAL <br />SUBTOTAL 3 <br />_ <br />PFRMIT f <br />PERMIT S <br />_ <br />TOTALFEE 8 <br />TOTAL FEE S <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />MEAN SETBACK SIDE SETBACK PLAN CY.ECh NUMBER t PLAN CHECK FEE <br />w/- FEE <br />I-1i^ RECEIPT NO <br />USE ZONE LOTANCA _ <br />R 5 I-L (]YES VACANT SITE <br />FEES VALUATION FEE <br />1000 ) 7N <br />TYPE OF CONS} OCCUPANCY GROUP NO. UP DWELLING UNITS <br />SI]E OF IILCG 140 OF :IORIES MAX OCC LOAD <br />21i1 se nDYLI 1 11 (nav'IJ) <br />FIRE <br />IIUIIONpY II`LhNS CII[Ch�Y INEAPPR FOR ISSUN <br />, L.c <br />BUILDING S IGI �cx 1 '1 7� U C <br />PLUMUR:O <br />MECIIANICAL <br />OTHER <br />ZL) Ei'�7-�{lJr� ;1�L�Tj %'GiGvs <br />