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PIPPLICATION FOl. r��,�„ <br />CITE "° <br />CITY OF CONSTRUCTION <br />OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK- PLEASE PRINT / <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL m PLUMBING ❑ SIGN <br />OWN, R n \ IAAII. ADMIT `` CIT`Y,�� ` lllr PlIONE -- <br />ARCHITECT OR DIt 910NFI rAAll ADDREN^, VOI 11W PHONE <br />GENERAL CONTRACTOR "All ARMESN ---- '''IV lip PHONE '.ICENSE <br />AIL CIIANC .Ai CONIRACIOII rlAll ADRIFT.$S -- City lip PIIONF. IICENSE A <br />❑ NEW WADDIIION ❑ ALTEnAII0N ❑ REPAIR_ ❑ DFMT)LIIION ❑ W00?ST0VEIFRPt INSERT ❑ BUILDING nELOCAtION- <br />VALIIA]OFF (IF AI IIU ICOSI III AIA I T Rb1LT I'IN;R LAIInIII <br />UI SCIIIIII \Vl llln <br />u+r or n1;n <br />ilm � _ <br />L1:C.At nF SUIPITIw OF- PROPERTY INIOWp TELOVI On ATTACH -OUR COPIES <br />LOI-BLOCK 0' <br />I HEREBY CERTIFY TI1AT I HAVE READ AND EXAMINED THIS AP- <br />PLICA'1IONAND KNOW TH E SAM E TO BE TR U E AND CO R RECT. AI.L <br />PROVI SI ONS OF LAWS A N U ORD I NA NCES GOVE R NI NG TH IS T YPE <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 AUTUOnIZED AGENT DATE <br />•'bPl' tptl�lvnlI51NG:SIIftNnFNp- <br />L <br />< <br />PROJECT ADnIlF55 <br />1 <br />PLUMBING .. <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATEn CLOSET (TOILET) <br />AIC - A,HNOLG UNITS - 11 P <br />BATHTUB <br />REFRIGERATION UNITS -IfP EA, <br />LAVA -DRY IWASII BASIN( <br />10 <br />BOILERS - EIJ U Ili P <br />SHOWER <br />GASFIREDAC UNITS-BT.U. <br />KITCHEN SINK A DISP <br />FOnCEO Ain SYSTEMS - B T U. M EA. <br />- <br />DISHWASHER <br />WALL HEATERS - B T U M <br />LAUNDRYTRAY <br />UNITIIEATEnS'-B.T.0 M <br />CLOTHESWASHER <br />-r� <br />EVAPOnn TIV-COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />L- <br />RANGE IIOOD <br />BACKFLOW PREVENTEnS <br />WATER HEATF.n <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - B: ". STC I <br />6 j <br />METAL FInEPLACE d CIiIMNEY <br />_- <br />- <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL f <br />-`(/(i <br />SUB TOTAL <br />PERMIT f <br />_ <br />PERMIT <br />co <br />TOTALFEE f <br />TOTALFEE <br />I IIOrli SF lOnCk <br />PLAN CHECK NUMBER <br />PEE <br />RECEIPT NO <br />REAR SETBACK <br />SIDE SETBACK <br />_ <br />DR[(OBI <br />1.01 ART <br />VACANT cmr <br />IIVFR IIlO <br />— <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />5 <br />TYPE OI uTNST <br />OC.curnNCv rnnur <br />'u) id rHA I'LLINI: onus; <br />---- ---- <br />SilE OT FITOU <br />NO UT MOTIFS <br />MAR OCT ROAR <br />MECHANICAL <br />Gy � <br />/ <br />,J U <br />01HER <br />FIRE SPRINKLERS REQUIRED ❑ YES U NO <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPIICADFIN AIY. By <br />PLfIlSCIIECKED BY <br />AITn Eon 14SNA1lCF KY <br />PUBLIC WORKS <br />TOTAL <br />I ' <br />q <br />✓ <br />I'IIVr•t.IH T UYrncoJ IVIC <br />PROPERTY LINE LOCATIONS AND BELA t ED EASEMENTS. <br />