Laserfiche WebLink
tn. tY.,Dn.n <br />city of <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />%PPLICATION FOh. <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />Cl DEMOLITION <br />❑ COMBINATION p9 BUILDING <br />I MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />OWNER <br />MAIL ADDRESS <br />CITY <br />PHONE <br />au� i Jl� Pr <br />/� 7 .Qi�I — Z afSl �Yw <br />pzip <br />w .✓. w��I_ 9/AAS'E� <br />ARCHITECT OR DE SIGNER <br />MAIL ADDRESS <br />CITY IIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY IIP <br />PHONE <br />LICENSE <br />.4511 rifsJ.Ar <br />�O Oar Z2sf'/ 6-y wiifzi, <br />/.tw <br />3610`4 r1r' O"'Afof <br />4!/l2/yG <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY IIP <br />PHONE <br />LICENSE <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION <br />VALUATION OF WORK (COST OFLAATERMLS PLUS LABOR, <br />USE OF BUILDING <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATIONAND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCES GOVERNING 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 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />LEGAL DESCAIPTIONOF PROPERTYISHOWN BELOW OR ATTACH FOUR COPIES' <br />p,S .- G+.ft ri�.+c <br />LOTLLBLOCK OF <br />PROJECT ADDRESS <br />14(5 - )aaKd <br />APPLICANTS CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />Z <br />WATER CLOSET ITOILETI <br />0 <br />A,C- ATHNDLG UNITS -HP <br />/ <br />BATHTUB <br />REFRIGERATION UNITS - HP EA. <br />L <br />L: VATORY (WASH BASIN' <br />BOILERS -8TU,HP <br />SHOWER <br />GAS FIRED A C. UNITS - B.T.0 <br />/ <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS - B T U M EA. <br />DISHWASHER <br />WALL HEATERS -B T.U. M <br />LAUNDRY TRAY <br />I <br />I UNIT HEATERS - B.T U M <br />/ <br />CLOTHES WASHER <br />URINAL <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />�J <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />�- <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />IF <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC) <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />f <br />SUR TOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTALPEE <br />f <br />ZL <br />TOTALFEE <br />'RUNT St TEA, <br />PLAN CHECK NUMBER <br />S�7 <br />FEE <br />v <br />RECEIPT NO <br />905 <br />REAR SETBACK <br />ez-AC <br />SIDE SEIBACK <br />L`e <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />A <br />. ` <br />(_f <br />TYPE OF CO ST <br />- N <br />OCCUPANCY GROUP <br />R. � <br />NO OF DWELLING UNITS <br />PLUMBING <br />S <br />SIZE OF SLOG <br />Iz3y t GnR 100 <br />NO OF STORIES <br />MAX OCC LOAD <br />Al, 4t <br />MECHANICAL <br />OTHER <br />la <br />FIRE SPRINKLERS REQUIRED O YES 0 <br />STATE BUILDING SURCHARGE <br />STATE ENER.. I SURCHARGE <br />APPOCATIONACC BY <br />A'/�1 <br />',� <br />Y�/1 / <br />PLANS CHECKED BY <br />S e- <br />APPR FOII ISSUANCE BY <br />PUBLICWORKS <br />T9TAL <br />/ <br />PROPER, F LINE LOCATIONS <br />A IONS .. D <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS <br />IIc,t3 114.17 <br />11.67 <br />