Laserfiche WebLink
..PPLICATION FOR. - <br />the ELA <br />city OF CONSTRUCTION <br />CONSTRUCTION O <br />LITY Of <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN <br />JOINT" MAIL ADDRESS UM1 EIPi£'1Sy' PHONE ' ' .`'— <br />ARCHITEC I OR DESIGNE R MAIL ADDRESS lily ar I—— <br />Gl NI P CONTRACTOR <br />MAIL ADDRESS <br />CITYN ZIP <br />PPHnN! <br />6'.11'G <br />LICENSE F <br />r <br />1L / <br />i/ n /7r <br />SG' .. 4: <br />6 <br />q y �C�c <br />< <br />/yj �� <br />r <br />kit i IILNn'M CONTRACTOR <br />MAIL ADDRESS <br />LILY ZIP <br />PHONE <br />LICENSE <br />PIuMBU111CONIRACTIV1 <br />MAIL ADDRESS <br />UTY ZIP <br />MOUNT <br />LICENSE• <br />Ll A65 DI YNNA <br />❑ <br />❑ ALTERATION ElREPAIR <br />❑ DEMOLITION Cl WOODSTOVEIFRPL.INSERT ❑ <br />BUILDING RELOCATIOFI- <br />❑ NEW ADDITION <br />VAIUAN. <br />LSPLUSLABOM <br />0 L)FIDO�510F Iant <br />OF Sc"mE WQK <br />�}t->•ss •�cc v - -- <br />I'M ar nun um') <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TOBE TRUE ANDCORRECT.ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING THIS TYPE <br />OF WORKWILL BECOMPLETED WITH WHETHER SPECIFIED HERE - <br />I EGAL DE SCRIPHON OF PROPERTY ISH WN 9EL OW ORATT IT OURCONEM <br />/%G�����t� <br />IN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />JOT BLOC« —_OF---.= <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 />SIGNATURE OF CONTRAGIOR OR AUTHORIZED AGENT DATE <br />t <br />PROTECT ADDRESS 70, <br />APPLICANTS coy ouw"f SS LICENSE NO <br />.- <br />PLUMBING <br />MFCHA_NICAL <br />- <br />NO. TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />_ <br />-_ WATER CLOSET(TOILET) <br />AIR COND UNITS-H.P. EA. <br />t BATHTUB <br />REFRIGERATION UNITS-H P. EA <br />BOILERS-H P. EA. —_ <br />�- <br />LAVATORY WASH BASIN) <br />SHOWER <br />OAS FIRED AC. UNITS -TONNAGE EA <br />KITCHEN SINK E DISP. <br />�J <br />FORCED AIR SYSTEMS-B.T.U. M EA <br />_ <br />DISHWASHER <br />WALLHEATERS-BTU M <br />LAUNDRYTRAY <br />UNITHEATERS-BTU. M <br />—L <br />CLOTHES WASHER <br />WATER HEATER <br />EVAPORATIVE COOLERS <br />LO1HE R FI <br />— <br />—_ <br />URINAL <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />DRAIN <br />AIR HAl10UNG UNIT- C F M. __ <br />_ <br />_FLOOR <br />VACUUM BREAKERS <br />STOVE <br />— <br />_ <br />ROOF DRAINS-RAINLEADERS <br />SINK ISERVICE-BAR. ETC <br />METAL FIREPLACE E CHIMNEY <br />WOODSTOVEEIF-IRE—PLACE INSERT <br />) <br />_ <br />_ <br />B <br />SUBTOTAL <br />SUBTOTAL <br />PERMIT <br />PERMIT B <br />_ <br />TOTAL PER <br />B <br />70TALPEN FIT <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />FRONT SETBACS PEAR SETBACK MDR SETBACK PLAN CHECK NUMBER PI AN CHIC' FELL <br />] C �. (EE %/ RECEIPT NO �vilsf n <br />USE ZONE LOT AREA VACANT BITE qp VALUATION FER <br />DYES UNO <br />ILrl Or t'ONBT OCCUPANCYGROUP NO OF DWELLING UNI•K _ <br />BUILDING R _ �� <br />mien <br />SIZE OF nI DO NO OF STORIES MAX OCC LOAD �� <br />1 PLUMBING <br />IED DYES ONO <br />MECHANICAL <br />OTHER <br />PENALTY -- <br />PLA"SCHICKEDDY <br />IS,,- <br />APPR FOR ISSUANCE BY <br />I (' 'G <br />TOTAL <br />