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, .PPLICATION FOk P,rTPII <br /> CITY OF TECONSTRUCTION <br /> uof <br /> everett PERMIT <br /> SUII.D DEPARTMENT <br /> 269.881010 TO BE COMPLETED IN INK• PLEASE PRINT <br /> D DEMOLITION O 070MOINATION O BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br /> DINNER .MAIL ADDRESS cm ZIP PHONE <br /> t:t�{ Ir r IT'/ ] - UcSS <br /> U`-/ I h Lr lr'II ( G S t ] Cr nlulE t lP-A LLC. 1'// I-- -PHONE <br /> A CHRECIORDESIONER MAR AOOaF!! C = <br /> UEPIERALCONI�NZACIOR MAIL ADDRESS CITY IIP PPONF LICENSE • <br /> S F'f„ r–viTf1 E 41 IF, ?itr GS 09 C-0)" lylCpIrf /—` <br /> ] n �•-e7� -- <br /> MECNANICALCONIRACTUS MAIL ADDRESS Cw IP PlIONE lN:[N 1 <br /> JU�I/r, p, 5robtra Is-F2 <br /> PL UMBINOLONIRACIOR MAIL ADDRESS CITY ZIP P ZONE L Lt ISE <br /> cLj NEWoar❑ ADDITION ❑ ALTERATION ❑ REPAIR Cl DEMOLITION ❑ WOODSTOVE/FRPL.INSERT 13 BUILDING nEIOCAnpr1_ <br /> VALUATION OF INDIA"ICON'Or MAIIRN1111 FLU!LABOR. <br /> r <br /> mfcRlse woaF - / <br /> u r emtolN 1 1 HEREBY CERTIFY THAT I HAVE READ AN'T EXAMINED THIS AP- <br /> PLICATION AND KNOW THE SAME TO BETA, F.ANDCORRFCT.ALL <br /> UGAL OESCRIPTION OE PROPERTY ISNOWN BVLOWO.ATTACNTOURCONESI PROVISIONS OF LAWSAND ORDINANCES GOVERNING TI. STYPE <br /> OF WORK WILL BE COMPLETED WITH WH ETI4ER SPECIFIED 11ERE- <br /> L0?_BL000L_OT IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> L ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> _. OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> X � LY� All )-/f %EI J2- <br /> APPLICANTS CITY BUSINESS LICENSE NO <br /> P110JECTADDRE55 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE No. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET 1 TOILE T I AIC–AMNDLG UNITS–H P <br /> BATHTUB REFRIGERATION UNITS–H.P EA. <br /> LAVATORY I WASH BASIN. BOILERS–B.i U M P. <br /> SHOWER GAS FIRED A C.UNITS–B T U. <br /> KITCHEN SINK A DISP FORCED AIR SYSTEMS–B T U M EA <br /> OISHWASNEN WALL HEATERS–B.T.U. M <br /> UUNORY TRAY UNIT HEATERS–B.T.U. M —� <br /> CLOTHES WASHER EVAPORATIVE COOLERS r— <br /> CLOTHESDRYERS <br /> URINAL <br /> pRINKINO FOUNLAtN <br /> VENTILATION FAN <br /> FLOOR DRAIN <br /> RANGE HOOD 1 <br /> BACKFLOW PREVENTERS WATER HEATER _ <br /> ROOT GRAINS—RAINI.EADER$ WOOD STOVE <br /> METAL FIREPLACE A CHIMNEY <br /> SINK(SERVICE–BAR.ETC 1 <br /> •7 I <br /> FIIIEPLACE INSERT <br /> HEATPUMP <br /> GAS PIPING <br /> EKHAUSTFAN –� <br /> 6UB TOTAL f SUB TO tAL <br /> PERMIT f PERMIT <br /> TGTAL FEE I <br /> TOTAL PER ! <br /> .SUPO SF.DAC" <br /> .LAN CHECK NUMBER FEE RECEIPT NO <br /> Bt AD SEISACK SIDE SETBACK <br /> USE:ONF LOTAREA VACANT SITE FEES VALUATION FEE <br /> DYES ONO S <br /> BUILDING <br /> IYPE Of CONS' OCCUPANCY GROUP NO OF DWELLING UNITS <br /> PLUAIBING <br /> SIZE J1 BLDG NO OF STORIES MAX OCC LOAD ' <br /> MECHANICAL <br /> OTHER <br /> FIRE SPRINKLERS REQUIRED 0 YES 0 NO STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> APPtICA110NACC BY PLANS CHECKED BY APPR FOR ISSUANCE BY PUBLIC WORKS <br /> I It <br /> PROPERTY <br /> TOTAL <br /> PROPERTY UNE LOCAWNERS TIONS NE RESPONSIBLE FOR NQ ALL <br /> ONS ANDRELATED EASEMENTS. <br /> P <br />