Laserfiche WebLink
itFnrymn Ilt'PPI-ICATION FOb,' P)PITI, <br />ITT OF CONSTRUCTION <br />Everett PERMIT <br />WILDING DEPARTME14T <br />59-8745 TO BE COMPLETED IN INK. PLEASE PRINT <br />I DEMOLITION O COMBINATION G1 BUILDING 0 MECHANICAL 0 PLUMBING 0 SIGN <br />•./qyER MAIL ADDRESS CITY ZIP PHONE <br />`l :l r r r) I C. )MAIL <br />J LI0�1'-IT-I u: � . E JC10 �14�L103 JL.j --7 U(c-7 _ <br />'\ ill L,,j <br />IC- 1.)11.) <br />vlo <br />'ttaAUf.1L111CV1;Nf <br />:J ("-15Ou <br />NEPAL CONTRACTOR <br />AIL ADORERS <br />CITY <br />ZIP <br />y <br />PHONE <br />PNONE _ <br />QZ71-1OM <br />LICENSE• <br />R`ISSC��t7' <br />I��Jr i�7FtIF� <br />-GnC <br />C14ANICAL CONTRACTOR <br />h <br />'clka Ic �1>cc-I <br />MAIL ADDRESS <br />Il lc`� Gi L 1 <br />I 111a-1 IaL�_ <br />IfY <br />I ly I E <br />NGiK Kli.•�I1 <br />ZIP <br />C^ <br />I�U�S� <br />PHONE LICENSE <br />1"EL.1 11911 It <br />-iJ3-�.& Ll IR5 <br />UMBINOCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />1 nc� <br />PIN)NF LICENSE!, <br />3-ON&I%1•4 <br />I l%YID11 �] �IIJYn bit lCl <br />tj Q.;J7 J0J11 ��" <br />�:.uJ• 41=L1'-Idttrl�ln_•)r_i.Il�l� <br />18011n <br />7%rJ-C:I(p'10 1-11DN <br />�OF OBK . <br />ASS <br />J NEW ❑ ADDITION ❑ <br />ALTERATION ❑ REPAIR <br />J <br />I3 DEMOLITION ❑ <br />WOODSTOVE/FRPLINSERT ❑ BUILDING RELOCATION <br />IUA�IION OF WDRKTCOSTOr MMF 11M1S PLUS ueOPo <br />/y <br />E )1. (?X�C) _120- <br />1rr1I <br />I ,I <br />E or eu DINa <br />1 HEREBY CERTIFY THAT HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOWTHE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF 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 />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Of CONTRACTOR OR AUTHORIZE ENT DATE <br />,IALDEACRIPIIDN OF PROPERIY1811UWNOELOWDRAIIACHFOUSCOPIER <br />4—BLOCK or <br />I - <br />h JC11d VI`sl:a 4�Itue IY bC DO <br />% -too• LD•I 9j 1 (')t1� Llj �) 1' 1: (1� A\ ILL[) f <br />�y� s <br />L of J ".P <br />'OJECT ADDRESS <br />APPLICANTS CITY BUSINESS LICEN NO \ <br />LUMBINO <br />MECHANICAL <br />TYPE OF EQUIPMENT <br />NO. <br />TYPE OF FIXTURE <br />_FEE <br />NO. <br />WATER CLOSETITOILEII <br />/S <br />(Sv <br />—FEE <br />AIR COND. UNITS-H.P. EA <br />7 <br />BATHTUB <br />�Oco <br />Q <br />REFRIGERATION UNITS-H.P. EA <br />LAVATORY IWASH BASIN) <br />CO <br />BOILERS-M.P. EA <br />SHOWER <br />OAS FIRED AC. UNITS -TONNAGE EA <br />KITCHEN SINK S DISP. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />DISHWASHER <br />ES <br />110 <br />ALL HEATERS-B.T.U. M <br />I <br />LAUNORYTRAY <br />CV <br />UNIT HEATERS-B.TIL M <br />CLOTHES WASHER <br />I EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />. <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C.F.M. <br />VACUUM BREAKERS <br />—I^ <br />STOVE <br />ROOF DRAINS-RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />_ <br />SINK'SERVICE-BAR ETC.1 <br />CID <br />_ <br />WOODSTOVE/FIREPLACE INSERT <br />3 <br />0 V <br />e <br />iv <br />SUBTOTAL <br />SUBTOTAL S <br />v <br />PERMIT ! <br />PERMIT $- <br />TOTALFE[ • <br />TOTALFEE • <br />Z <br />SV <br />ONI SETBACK <br />I � <br />rA <br />E OI CONS1 <br />r Al <br />E OF BLDG <br />_1.. . <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />REAR SETBACK SHOE SETBACK PLAN C-HECK UMBEn PLANCHECK <br />�1 .. 1. � I TJ /% iY1 CCE � 43 1t:j HE C II <br />LOT AREA {/L, I VACANT SITE U YU�L`Ois 3 <br />01 I t ❑YES IKIO FEES VALUATION <br />ACT. BY <br />'3cv; <br />ron ISSU WCE By <br />L.G. <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />M <br />