Laserfiche WebLink
Hc��l <br />A D1 <br />a11-3 W i <br />y X <br />K n <br />H �l <br />ro 1'x-.1 Eq <br />y H <br />H r <br />HC <br />�� g <br />MN 0 <br />r H <br />g` H <br />(t lz) to <br />C C <br />latn <br />H30W <br />C:—D <br />APPLICATION FOk <br />" <br />irvOF°'"" <br />CITY CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-881C TO BE COMPLETED IN INK- PLEASE PRINT <br />259-88 <br />0 DEMOLITION ❑ COMBINATION )L HiJILDING 0 MECHANICAL <br />R <br />0 PLUMBING <br />0 <br />❑ SIGN <br />MAIL ADDRESS <br />GT, <br />lip <br />PRONE <br />LICENSE <br />MAIL ADDRESS <br />crry <br />tlr <br />mwNE <br />ucr NSE <br />,`� --- <br />......nner•• <br />CITY <br />DP <br />MIONE <br />MLNSE • <br />CLASS OF WOPA <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPLANSERT ❑ BUILDING RELOCATION_ <br />VALUAiONGFWORKICOSIO ATTPIA rWSLASORLI ` L \ / / /lAn 07 <br />WORKA I /\ -Y. <br />USE OF BUILDING F • <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOWTHE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THISTYPE <br />(COAL DESCRIPTIONCIF PRR RTYIBNOWM BE OR ATLLn TOUR CONES( <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOI�. REocK__oF <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATED LOCAL LAW REGULATING CONSTRUCTION <br />OR E PER FO I A E OF CONSTRUCTION. <br />SIGN E:'UN1nA CtnAIITLJRIIIII AGENT hAi[ <br />PROIFCIADDATSS A <br />APPUI A' 'r SUSINESSPCENSE <br />MECHANICAL <br />PLUMBING <br />— <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />A/C - A/HNDLG UNITS - H P <br />-�`- <br />WATER CLOSET (TOILET I <br />REFRIGERATION UNITS - HP EA <br />_Z <br />BATHTUB <br />LAVATORY (WASH BASIN( <br />BOILERS - 0 T U IH P <br />GASFIREOAC UNITS -BTU <br />SHOWER <br />FORCED AIR SYSTEMS - B T U M EA <br />KITCHEN SINK S DISP <br />DISHWASHER <br />- <br />WALL HEATERS -BTU. M <br />UNIT HEATERS - B T U M <br />LAUNDRY TRAY <br />EVAPORA'VE COOLERS <br />ASHER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />JUNTAIN <br />SFOUNTAIN <br />IN <br />RANGE 14000 <br />FIREVENTERS <br />WATER HEATER <br />S - RAINLEADERS <br />WOOD STOVE <br />METAL FIREPLACE 6 CHIMNEY <br />CE - BAR. ETC I <br />FIREPLACE INSERT <br />HEAT PUMP <br />-- <br />GAS PIPING <br />EXHAUSTFAN - <br />SUB TOTAL E <br />SUBTOTAL <br />PERMIT f <br />PERMIT <br />TOTAL FEE SJC <br />TOTAL FEE <br />RAN L:HECK NUMOE <br />FEE <br />RECEIPT NO <br />REAR 9EIOBACK <br />2 <br />SIDE BCIOACK <br />` <br />_ <br />i.-.I rGAtK / <br />p, <br />Q <br />I/ <br />USE N! <br />IOi AREA <br />VA ANT SOL <br />EES <br />VALUATION <br />FEE <br />S <br />�- <br />_ <br />N L <br />G GNG <br />BUILDING <br />TYPE Of CONST <br />OCC PANCY'GRO P <br />of DMIEING UNITS <br />J." <br />.�_ <br />_2 <br />PLUMBING <br />2[ <br />S.JL OF BLDG <br />NO Of STORES <br />MAX OGC LOAD <br />MECHANICAL <br />2l <br />A I <br />Z.. <br />OTHER /S_ ICG <br />i <br />STATE BUILDING SURCHARGE <br />^^� <br />FIRE SPRINKLERS REQUIRED ❑ YES t7-BIo <br />STATE ENERGY SURCHARGE <br />S <br />APPLICAITN ACC SY <br />r'I ANS CNECKEO BY <br />APPR fOR ISSISSUANCE BY <br />PUSLICWORKS <br />TOTAL <br />^ <br />u .v nwc Rc ARP aesPSI ONBLE FOR DETERMINING ALL <br />PROPERTY LINE LOCATIONS AND RELATED EASEMENTS. <br />