Laserfiche WebLink
aPPLICATION FOk ' <br />CITE""°'"R CONSTRUCTION O <br />CITY OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259.8810 TO BE COMPLETED IN INK• PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN <br />MAIL Anmus.1 rnr .�j prlfr PPURI <br />I l.r'l/.rrn, %n�is /IIm ^Y/' /�I.11 _�� <br />Ol btaAL LOh MLTOR 7 MMI APLlaE 99 L11Y llr INTNI II( t"', A <br />MI CIIANn{❑ CIIIIOVIC111R —It ADDRESS C111 /IP InnNl Ilff rKi• <br />PLUMRIIMCONNIIC10R Mbl ADmIESR If ZIP PUDNI Oft-1-1 r <br />L wea..• <br />❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR ❑ DEMOLITIO'J ❑ WOODSTOVE;FRPLINSERT 13 BUILDING FILLOCATION <br />VAL UA VON Or MI.V 1(..791 nl IIAII IIIn L'.1`I Us 1 ARnln <br />ice_ lA.l / <br />DF SC R WON- 1 <br />ff-EL. Ali- e VI .` i r .... <br />�. <br />-. -. <br />USE DI RUILDNIn <br />1 HEREBY CERTIFY TI rAT I HAVE READ AND EXAMINED THIS AP. <br />PLICAT ION AND KNOW THE SAME TO BE TRUE AND CORRECT.AtL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING T I IIS TYPE <br />LT OAL DI .mrnon nr Pnoruar duPreNnn ow nnAnu:u rraJn Lunn nl <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />Lol_DIoc, -OF <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 />SKINATUr1r OF CONTPACTCR On ALITHornim AGTNI ❑ATF <br />PRDJtLT ADORE99 <br />Arrll. NB LIIY BN$INE9911I111LFNO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILETI <br />NC - A/HNOLO UNITS - H P <br />REFRIGERATION UNITS - H P EA. <br />BATHTUB <br />LAVATORY ( WASH BASIIJI <br />BOILEnS -BTU /H P <br />GAS FIRED A C UNITS - B T U <br />SHOWEn <br />FORCED AIR SYSTEMS - B T U M FA <br />KITCHEN SINK [ DISP <br />DISHWASHER <br />WALL IIEATEnS - BTU M <br />-� <br />UNIT HEATERS -B.TU M <br />LAUNDRY TRAY <br />CLOTHES WASHEn <br />EVAPOnATIVE COOLERS <br />CLOTHES DRYEnS <br />URINAL <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />nANGE HOOD <br />BACKFLOW PnEVENTFn., <br />WATER HEATER <br />POOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAD ETr I <br />METAL FIREPLACES CHIMNEY <br />FIREPLACE INSERT <br />HEATPUMP <br />OAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />4 <br />SUB TOTAL <br />-� <br />PERMIT <br />t <br />PERMIT <br />TOTAL FEE <br />4 <br />TOTALFEE <br />1K AN CHECK NUMBER <br />FEE- <br />RECEIPT NO <br />SIDE SE TBAC:K <br />I NONT Sf TDM-.. <br />nl AN s1 IBAv <br />USF InNI <br />Lm AnrA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />s'�DOU <br />O.ES nNO <br />BUILDING <br />3 <br />hrt Or FnnSI <br />IN:COPANCV GnOUP <br />NO OF DWrLLING URI 19 <br />PLUMDING <br />911E OI III no <br />I'll nI WDTnr9 <br />MAX OCC LOAD <br />MECHANICAL <br />OTHER <br />- <br />STATE BUILDING SURCHARGE <br />FIRE SPRINKLERS REQUIRED U YES O NO <br />STATE ENERGY SURCHARGE <br />_ <br />AI II ICAIION A..0 D. <br />PI AN'. I:HECKED Dr <br />ArrO FOR ISSUANCE By <br />PUBLICWORKS <br />TOTAL <br />PROPERTY LINE LOCATIONS AND RELAfEU EASEMENTS <br />r <br />■ <br />