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APPLICATION FO._ PYrTPtl <br />theTAREOF CONSTRUCTION <br />OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259.8745 TO BE COMPLETED IN INK • PLEASE PRINK <br />O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER ��A.//MAIL ADDRESS CITY �' ZIP PHONE <br />, ,a- I— H �.r. /7x pdRI4 .'i�uiA U� �/r .A.t.r clew ii Li.0573 : i�Ci''- 5� <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION <br />Y <br />USE OF BUR DING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TH E SAME TO BE TRUE AND CORRECT, AL L <br />PROVISIONS OF LAWS AND ORD I NANCE S GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PE RM IT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIINATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTION OF PROPERTYISII WN BELOW OR ATTACH rpuRCOPIES <br />LOT_!� BLOCK_oF v <br />- <br />PROJECT ADDRESS <br />LL U,, <br />APPLICANTS CITY II SITLB9 HCLNSE NO <br />PLUMBING <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE <br />—7FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />.!7 <br />WATER CLOSET TOILET <br />_ t_ <br />AIR COND. UNITS-11 P. EA <br />Z <br />BATHTUB <br />__� <br />REFRIGERATION UNITS-H P EA <br />;Y <br />LAVATORY IWASH BASIN) <br />io <br />0011 ERS-H P. EA. <br />SHOWER <br />GAS FIRED AC. UNITS -TONNAGE EA <br />KITCHEN SINK DISP. <br />FORCED AIR SYSTEMS -BTU. M EA. <br />DISHWASHER <br />LAUNDRY TRAY <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-OT.U. M <br />_ <br />CLOTHES WASHER <br />07 <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANOE HOOD <br />_ <br />1542 <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C.F.M. <br />_ <br />VACUUM OREAKERS <br />STOVE <br />ROOF DRAINS-RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK SERVICE -BAR ETC. <br />WOODSTOV&FIRREEPLLAACE INSERT <br />im <br />SUBTOTAL <br />lI <br />SUB TOTAL III <br />d <br />_ <br />PERMIT <br />TOTALFEE • <br />II <br />PERMIT <br />TOTAL <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL rrr111 fIBACK ,I REAR SETBACK BIDE SETBACK WA _1 I U.'?� � � FEE BAN CHECK FEE <br />RECEIPT NOES" rZ S (2� <br />E LOT AREA y CANT/BITE I 1 `�"f-V <br />I!!B VALUATION r!! <br />I�YFB ONO D <br />CONST OCCUPANCY GROUP NO OF DWELLING UNITS <br />E <br />BUILDING <br />z <br />SIZE OF BI. DO [ <br />II � 'f E/OII <br />NO OF STORIES <br />I <br />MAX OCC LOAD <br />PLUMBING <br />Cp <br />FIRE SPRINKLERS REOUIRED ET YE9 ONO <br />MECHANICAL <br />OTHER <br />PENALTY <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR 199uANLE BY <br />L.G. <br />TOTAL <br />L <br />