Laserfiche WebLink
.. - . <br />.. .. , , . . . ,. :.,; ...-..N <br />rn� r.+.o�«n <br />CIiY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />r.PPLICATION FOI. <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING �SIGN <br />OWNER MAIIADDHE55 CiTY ZIP pNONE <br />I/� 3�laN� I�m�c 9��o ia'�` s� EUElGT 48�o s �� i- C�y�1� <br />ANGNiiELTOR�E5IGNER MAILADDflESS CiTV LP PHONE <br />PWMBINaCONTR4CiON MAilA00AE5S CITV Z�P PHONE uf.Ef15E• <br />lYJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPL.INSF.RT ❑ BUILDING FELOCATION <br />VAl WTION OF WORN ICOST OF MAiEFUlS PLUS LRBONI <br />� 00 U U'— <br />��.1Sra.c..L � �IF- F2EEsrp.r-iDir-lEt s�Cytil <br />VJL V� tlJ�lVlliV <br />r+tJ"Yv- t— s A LES <br />BELOW UR ATTaCM <br />io�—s�oc� <br />q C� 1 U � 0. t"`= < <br />PLUMBING <br />NO. <br />wATER CLOSE7 (POILET� <br />BATHTUB <br />I.AVATORV IWASH BASIN'. <br />SHOWER <br />1lITCHEN SINK 6 DISP. <br />LAUNORYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINNINGFOUNTAIN <br />FIOOR ORAIN <br />ROOF DRAINS - RAINLEAC <br />SINK ISERVICE -BAR. ETC <br />SE•BACn <br />�� <br />iVPE OG <br />SUB T0TI1L <br />PEPMIT <br />TOTAL FEE <br />REnR SEIBACN <br />LOiNOEA <br />OCCUPNNCYGRO <br />NO OF StORIES <br />E ��E2E � <br />vue su nn�n <br />VAGNt SiIE <br />❑YES ONO <br />NO OF DW[l <br />MnX OLG LOAO <br />APPUC/.110N ACC OV PUN: CHEGHEO BV APPR FOR ISSUI <br />v.� � <br />� HEREBY CEflTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT. ALL <br />PRQ`!ISIONS OF LAWS AND ORDINANCESGOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIO! ATE OR CANC[L THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW P.EGULATINGCONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />SIGNAfURE OF CONiRRCTOR OR qUTNORIZE� AGENT DATE <br />�� ( �-f� S —� � 88 <br />�PPLICANTS CItV UlI5iNE55 LiCENSE NO <br />3 3 �-1`1 ( <br />MECHANICAL <br />TVPE OF EOUIVMEN7 <br />A/L - A/HNOLG UNITS - HP. <br />PEFFIGERATION 11NITS - MP. EA. <br />BOIIERS - B.T.0 /H.P. <br />GAS FIRED A�C. UNITS - d.T.U. <br />FORCED AIR SYSTEMS - B T.U. <br />WALL NEATEFS - 9.T.U. <br />UNIT HEATERS - B.T.U. <br />EVAPORATI�ECOOLERS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEP HEATER <br />WOOD STOVE <br />METAL FIREPIACE 8 CHIMNEV <br />FIREPUICEINSERT <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />PER/AIT <br />VLAN i.HECK Nl1MBEfl � FEE <br />FEES <br />8111LDING <br />PLUMBING <br />MECMANICAL <br />OTHER <br />STATE BUILDING SURCHARG <br />STATEENERG'fSURCHAPGE <br />PU�LIG WORNS <br />TOTAL <br />5 <br />M EA. <br />M <br />M <br />FEE <br />HECEIPT NO. <br />PROPERN OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROPERN LINE LOCATIONS AND RELATED EASEMENTS. <br />BG <br />