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APPLICATION FOR <br />TAP FYEIDIAan CONSTRUCTIONCITY Of <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO. E COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION O BUILDING F.1 MECHANICAL <br />MAILADORESS _ A - CITY ZIP <br />0 PLUMBING <br />O SIGN <br />Ga' �`' ��` �OxeK 9rEc /go�c�� E• o '7Y) ,,,,�&.Y <br />F� G/a <br />9F� y,3" <br />s�v S(o 73 �//��2 <br />L.n �G • �sroA <br />KN(CIfANICAL CONTRACTOR MAIL ADDRESS SS <br />CITT <br />ZIP <br />PHONE <br />• LCENSEJ�S <br />LICENSE• <br />PLUMBINOCONTAACTOR MAIL ADDRESS <br />city <br />ZIP <br />PHONE <br />' cL"R" <br />EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOV&FRPL.INSERT ❑ BUILDING RELOCA110N <br />OF <br />IIIIIIII LOT — <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATIONAND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OFA 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 CONTRACTO R AUTHORIZED AGENT DATE <br />�O i / <br />PROJECIADDRESS <br />APPL NTS CITY BUSIMMICENSEN <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET TOILE <br />AIRCOND. UNITS—H.P. EA <br />BATHTUB <br />REFRIGERATION UNITS—H.P. EA <br />LAVATORY JWASH BASIN) <br />BOILERS—H. P. EA. <br />SHOWER <br />OAS FIRED A.C. UNITS —TONNAGE EA <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS—B.T.U. M EA <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES WASHER <br />WATER HEATER <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />AIR HANDLING UNIT— C.F.M. <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK SERVICE —BAR ETC. <br />WOODSTOVETIREPLACE INSERT <br />BUS TOTAL <br />BUD TOTAL E <br />PERMIT S <br />PERMIT IS <br />TOTALFEE S <br />TOTALFEE f <br />I <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />p/ — <br />O Y7 <br />FEE IUL% <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />OCCUPANCY GROUP <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />F <br />TYPE OF CONS) <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLVD <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE SPRINKLERS REQUIRED O YES ❑ NO <br />MECHANICAL <br />OTHER <br />PENALTY <br />M.PLICAIIONACC BY <br />PLANC CHECKED BY <br />APPR FOR ISSUANCE BY <br />TOTAL <br />.INS <br />.m <br />. INS <br />