728 60TH ST SW 2016-01-01 MF Import

i r,PPLICATION Ill iffe Eve "°'"° CITyOF CONSTRUCTION CITY OF everett PERMIT BUILDING DEPARTMENT 259.8810 TO BE COMPLETED IN INK - PLEASE PRINT ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN OWNEf1 MMI ADDRESS CITY ZIP PHONI ��ra)Aiorl /y0A4rJ /J-07.t S"oLIF"' L`-,1�_Q ��nwo/IUFE 9doJ'2 Irl -al u Al I R OI 516NI[R MAIL ADDRESS CITY zip PHONE J�10/��(LIII/- OAsir J • MAIL Al ir R CITY IIP PHONEGEA/6l1f zaap LICENSE ISQ"4 P KN GIANIf.AI CONTRA[T(pl MAIL ADORES' COY LIP PHONE LICENSE or Y PLLMBINR CONTRACTOR MAIL ADDRESS CITY ZIP PIIONE LICENSE• CLASS Of WORK ell ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION VALUATION ti1;UB,D�,E�IPLEL9l/IB� � - DE SLBK 11 f// O/Ef -'YP N 2fl 1�-7I1 COC V D.4,ole /c -'619oll &00I u N USE OF BU'I DING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- .QA �� t i PLIC?TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL LE .ALDESCBIP,(ONO;OPERTYISHUWNBELOWORAITACIIFOURCOPIES' PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• J LOT_..p._BLa1L_—oF� INORNOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE X PROJECT ADDRESS APPLICANTS CITY BUSINESS LICENSE NO PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET ITOILETI — ASC-A,HNOLG UNITS-H P BATHTUB — REFRIGERATION UNITS-H P EA LAVATORY IWASH BASINI -' BOILERS-BTU•HP SHOWER GAS FIRED A C.UNITS-B T U KITCHEN SINK Q DISP '- FORCED AIR SYSTEMS-B T U M EA DISHWASHER —' WALL HEATERS-BTU M LAUNDRY TRAY UNIT HEATERS-B T U M CLOTHES WASHER ) EVAPORATIVE COOLERS URINAL CLOTHES DRYERS DRINKING FOUNTAIN hl I VENTILATION FAN FLOOR DRAIN RANGE HC OD BACKFLOW PREVENTERS WATER HEATER ROOF DRAINS-RAINLEADERS WOOD STOVE SINK(SERVICE-BAR.ETC) METAL FIREPLACE It CHIMNEY FIREPLACE INSERT HEAT PUMP GAS PIPING EXHAUST FAN BUB TOTAL f SUBTOTAL Jl 1 PERMIT f PERMIT TOTAL FEEf TOTAL FEE ) F PONT SE TBACw �OTf/jr RUR SETBACK SID�SETBACw ('LAN CHECK NUMBER FEE RECEIPT NO Es 20 7-0 _ II SE ZONE LOT AREA VACANT SITE FEES VALUATION FEE K l WE, ONO BUILDING TYPE OF CONST OCCUPANCY GROUP NO OF DWELLING UNITS PLUMBING SIZE OF BI OG 3 18a NO OF STnnn S MAX OCC LOAD MECHANICAL �Y Z OTHER FIRE SPRINKLERS REOUIRED D YES Sgo STATE BUILDING SURCHARGE STATE ENERGY SURCHARGE APPLICATION ACC BY PUNS CHECKED BY APPR FOR ISSUANCE BY PUBLIC WORKS TOTAL C... PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL PROPERTY LINE LOCATIONS AND RELATED EASEMENTS.