Laserfiche WebLink
, .PPLICATION FOA. ' kei <br /> '"FEY•'°"'" <br /> CITY OF CONSTRUCTION <br /> everett PERMIT <br /> TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br /> BUILDING DEPT. <br /> 259.8745 ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAIL ADDRESS CHI ZIP PIIONt <br /> �yj�HA Ohlson 318 - 77 PI• S .W. EVereff 982'3 3N7-238� <br /> ARL IIIEL1�0wn■DESIGNEN MAIL ADDRESS LIIV ZIP PHONE <br /> ��,' •�rCITY iIP PIIOIIC LICENSE <br /> GENERAL CONTRACTOR MAII ADDRESS <br /> owner CITYiIP PHGIIL LICENSE F <br /> MECHANI AL ONTRACT09 MAN AODDC59 <br /> PIUMBIN LOIHRACIOq MAR ADDnC 55 LOY ZIP PHONE LICENSE F <br /> CLASS OF WORK <br /> NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT ❑ BUILDING RELOCATION <br /> 0.UATION OF WORN ILOSI Oi LIAl1AMl S Pl DS UUOiII <br /> f b, <br /> D[scnmE wonK <br /> iOn 24, (._5ZQ. A 1 garage_wi _f"dafiQ,-wid lft extended d <br /> usE F Buu DINa I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> PLICATIONAND KNOWTHE SAME TO BE TRUE AND CORRECT.ALL <br /> tEGALDESCRIPTIOIAJFPROPERTYS116 Buow Dn An AalFo COPIES, PROVISIONSOF LAWS AND ORDINANCES GOVERN114G THIS TYPE <br /> OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br /> Lot—BLOCK—OF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Or <br /> l^{. `7 '( eg �Q ANY OTHERFORMOR ANCE OF LAW CONSTRUCTION.NG CONSTRUCTION <br /> 1S—L1—Ls. OR THE PERFORMANCE OF CONSTRUCTION. <br /> V( I' 2 o f Sna4,C"pal^ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> L J�I_yzf,Sd'2 11Y x <br /> -- APL ICANTS CITY BUSINESS LICENSE NO <br /> PROIELi ADDRE95 <br /> 318 771h 'PI. S.W. E ver ft 9820 <br /> PLUMBING MECHANICAL <br /> FEE NO. TYPE OF EOUIPMENT FEE <br /> NO. TYPE OF FIXTURE AIR GOND.UNITS-H.P.EA. <br /> WATER CLOSET TOILE <br /> REFRIGERATION UNITS-I1.1".EA <br /> BATHTUB <br /> _ LAVATORY WASH BAST BOILERS-H.P.EA. <br /> OAS FIRED A C UNITS-TONNAGE EA <br /> SHOWER <br /> KITCHEN SINK&DRIP. WALLED AIR SYSTEMS-B.T.U. MEA. _. <br /> WALL HEATERS-B.T.U. M <br /> DISHWASHER <br /> _ LAUNDRY TRAY UNIT HEATERS-B.T.U. M <br /> _ CLOTHES WASHER EVAPORATIVE COOLERS <br /> CLOTHES DRYERS <br /> WATER HEATER <br /> VENTILATION FAN <br /> URINAL <br /> RANGE <br /> DRINKING FOUNTAIN <br /> FLOOR AIR HANDLING UNIT- C.F.M. <br /> IN <br /> } <br /> VACUUM BREAKERS STOVE L <br /> _ ROOFDMINS-LAINIEADERB METAL FIREPLACE A CHIMNEY <br /> SINN SERVICE-BAR ETC. WOODSTO INSERT <br /> FIREPLACE <br /> i <br /> ff— <br /> SUBTOTAL SUB O AL <br /> PERMIT • PERMIT It <br /> TOTAL FEE & <br /> TOTAL FEE <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> PEAN CHECK FEE <br /> FRONT SETBACK �F PEAR 9EI�ACKE F BIDE SETBACK CHECK NUMB �� FEE �>� RECE'I M�c/� <br /> USE ZONE TOT AREA VAC6ANI,BITE CFEEB _-YAlUAT10N al Fit <br /> - I `,'ri 67 OYES O [-n <br /> TYPE OF CONST. OCCUPANCY GROUP NO OF DWELLING UNITS �,./y y�) • �(l <br /> U - m O BUILDING <br /> S ZE OF SLOG NO OF STORIES MAX OCC LOAD <br /> PLUMBING _ <br /> MECHANICAL <br /> FIRE SPRINKLERS REQUIRED O YES 13 NO OTHER <br /> PENALTY <br /> APPLICATION ACC BY PLANS CHECKED BY APPR FOR ISSUANCE BY <br /> TOTAL <br /> S-� l •G. <br />