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-.PPLICATION FOL,) <br />CITY OF EYE,°T"R CONSTRUCTION <br />CIT <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259.8745 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION &BUILDING 11 MECHANICAL ❑ PLUMBING ❑ SIGN <br />owl'[ l MAR AODFLSS CITY ZIP PRONE <br />NI),_///Wrl �i11111C1( ()Ck) 7,_�1 9CI�C�hI_I SIL C=O(—pt-1 T 3 '3-11 <br />AINHITECT OR Of SIONER MAIL ADDRESS CITY ZIP PRONE <br />GENERAL LONTF IOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />IICEIJtif <br />0,R7Nse- IIJ <br />13tct`f-�e <br />. <br />?208 cl<() Hall 97 <br />N, mi)t u0.5oa E I�FT�t�70 <br />l53-R5ia <br />u TKa�dL�4 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />•CITY `� ZIP <br />PHONE <br />LICENSE <br />PLUMRINRCONTRACIOF1 <br />MAIL AUDRESS <br />CITY ZIP <br />PROVE <br />LICENSE. <br />"A.i. HI WI)IIA <br />❑ NEW 0 ADDITION ❑ ALIERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSIOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />VALUATION n, WOnKICOS? OF OF MAILRRLS PILE LABOR) <br />Io <br />USE OF BUILDIN <br />-- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATIONAND KNOWTHE SAME TORE TRUEANDCORRECT. ALL <br />PROVISIONSOF LAWS AND ORDINANCES GOVERNING THISTYPE <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 />SIONATUAEEOF CONTRACTOR OR AUTHORIZED A ' NT DATE <br />x Yd1wATO e. 01k � � 1 �`t AlINI) Ki <br />LEGAL DESCRIPIION Or PROPERTYISHOWN BELOW OR ATTACH FOUR COPIESI <br />DCO ., AWL)OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE- <br />Lol eLoc or N CA -GI <br />PROJECT ADDRESS <br />7ZI I C)7I1 .� SIC, (-L)6-pC=7T Lt)d1 `dJOL <br />APPLICANT'S CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />_ TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSETITOILED <br />AIRCOND UNITS -HP. EA <br />BATHTUB <br />REFRIGERATION UNITS-H P EA. <br />LAVATORY WASH BASIN) <br />BOILERS -HP EA. <br />_ <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />_ <br />KITCHEN SINK& DISP <br />FORCEDAIRSYSTEMS-B.T.U. MEA <br />DISHWASHER <br />WALL HEATERS-B T. U. <br />LAUNDRYTRAY <br />_M <br />UNIT HEATERS-B. T.0 M <br />CLOTHES WASHER <br />_ <br />_ <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />_ <br />VENTILATION FAN <br />_ <br />_ <br />O"INKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT- CF.M. <br />_ <br />VAC JUM BREAKERS <br />STOVE <br />_ <br />ROOF DRAINS-RAINL E AVERS <br />_ <br />METAL FIREPLACE A CHIMNEY <br />SINK SERVICE -EAR, ETC) <br />WOODSTOVE/FIREPLACE INSERT <br />SUB TOTAL <br />SU_R TOTAL S <br />PERMIT 1 <br />_ <br />PERMIT 1 <br />TOTALFEE / <br />TOTALFEE 1 <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />IRON?Sf )BACK <br />Y 1 <br />REARSEIBACK <br />SIDE SETBACK <br />PLAN CHEC UMBER <br />LO <br />1 / 6d_� <br />PI AN <br />rEFn l�� <br />CHECK 4E <br />nLCnrnJ <br />USE ZONC <br />LOT AREA <br />VACA O <br />vAf,ANi SOE <br />FEES <br />VALUATION <br />PEE <br />IYPL OF CONST <br />OCCIIPANCY GROUP <br />NO Of DWELLING UNITS <br />BUILDING <br />S <br />Sllf Of fit DU <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />— <br />FIRE SPRINKLERS REOUIRLO IT YES O NO <br />MECHANICAL <br />Oi11ER <br />PENALTY <br />/ <br />Z <br />APPIICA?ION ACC BY <br />04 <br />rlAN3CIICCKED BY <br />APPR FOR ISSUANCE BY <br />TOTAL <br />^ <br />rt <br />V E) <br />