Laserfiche WebLink
IRE EYvOrsen ►,PPLICATION F0419 Ij <br />CITY OF CONSTRUCTION <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br />BUILDING DEPT. �{ <br />259.8745 ❑ COMBINATION ❑ BUILDING MECHANICAL -gPLUMBING ❑ SIGN <br />Q� <br />OWNER MAIL ADDRESS CITY ZIP PHONE t7w8�VIy UOr <br />n c 0_.., ",,n 4a <_L_ - j j•-...._..E,L- 1n1,,V. irl<,n 0 <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />�LL�'-�IEI 1355773C VALt_ENc, IF-53L� <br />MECHA I ACONTMC OR MAILADORrBB CITY ZIP PHONE LICENSEE <br />PLUMBINOCONTRACIOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />❑YyNEW V ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTIIVEIFRPL.INSERT ❑ BUILDING RELOCATION <br />oEsCRIBE WonK <br />I- I -rin_ ', ,-,.i- LI -+.n <br />IISE Or BWlDINO� 1 1 S <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONSO° LAWS AND ORDINANCES GOVERNING THIS TYPE <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 />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />LFOAL DESCRIPTION Or PROPERTYISHOWN BELOWORATTACH rOURCOPIESI <br />LOT_BLocK--or <br />-'- <br />PROJECT ADDRESS <br />`�r1 my c <br />APPLI NIS CITY BUSINESS LICENSEI] <br />6. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />T"E OF EQUIPMENT <br />FEE <br />WATER CLOSET TOILE <br />AIR COND. UNITS-H.P. EA <br />BATHTUB <br />REFRIGERATION UNITS-H.P. EA <br />LAVATORY LWASH BASIN <br />BOIL FRS-H.P. LA <br />SHOWER <br />GAS FIRED AG UNITS -TONNAGE EA <br />KITCHEN SINK f OISP. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />_ <br />LAUNDRYTRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />I EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />UNINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK SERVICE -BAR EIC,l <br />WOODSTOVEIFIREPLACE INSERT <br />In <br />BUD TOTAL <br />BUD TOTAL f <br />PERMIT f <br />PERMIT ! <br />TOTAL FEE • <br />TOTAL FEE • <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />REAR SETBACK &DE SEISACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />LOT AREA VACANT SITE <br />FEES VALUATION FEE <br />DYES ONO <br />YPE of CONST. OCCUPANCY GROUP NO OF DWELLING UNITS <br />RE OF BLDG NO OF STORIES MAX OCC. LOAD <br />IRE SPRINKLERS REQUIRED DYES ❑ NO <br />"PLICATION <br />c IIECKEn BY <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTITER <br />PENALTY <br />TOTAL <br />S <br />s <br />u <br />�m <br />L� rn <br />0 <br />EYE C) <br />ET <br />...I C: <br />0 <br />-1 Z <br />x <br />m <br />.o z <br />r- <br />rx_ <br />-T N <br />T <br />O <br />--I <br />Txn . <br />N <br />or <br />L7 m <br />C VI <br />m L0 <br />=Irn <br />. m <br />n <br />A <br />'I <br />S <br />D <br />z <br />v <br />G <br />c <br />m <br />I■ <br />