Laserfiche WebLink
��� <br />.��r�7'+ <br />C, H <br />ayxv� <br />y zH <br />� H� <br />O :. �7 <br />�J F� �T� <br />C/� H <br />z <br />�o� <br />HC <br />OH <br />� �� <br />4] u C] <br />�H� <br />HH <br />gy <br />H <br />c� C7 V� <br />� � [r�1 <br />Z H fA <br />H O fn <br />�� <br />� ��' <br />r a�-. rw��: <br />A�PLICATI�N FOR COPlSTRUC710N PERMIT <br />fhc 6rorgrcan <br />CIN OF <br />everett <br />BUILDING DEPF,RTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />'' DEMOLITION I.; COMBINATION � BUILDING ❑ MECHANICAL <br />X i-1���^a' l�c. Maaaooness p '� l'i(c p zia P� <br />��Or zc� �C�62 S� aere�}Y✓�411t�kc�/ �U Y`� �5'2.0� <br />TEN�NT 1I MqILA�DRE55 —T CIN 21P PI <br />� •..A ..T \\ <br />� <br />P�OMBING LONTRACTOR <br />ClA`..S OF Y/ORK <br />L � NEW ❑ ADDITION <br />TENANi II.IPPOVEMENT Ofl IN� <br />\A CONTFFCT PRILE OF WORK. <br />lAAIL ADDRESS <br />�z 5�� <br />MAIL FODRE55 <br />n+na nooness <br />CITv <br />cirv <br />ZIP <br />21P <br />=l� <br />ZIP <br />rnurvc <br />PHONE <br />L:'_PLUMBING <br />; —I 57� <br />LICENSE M <br />-�s�o <br />LICENSE a <br />everett <br />� <br />i:l .�'iIGN ' <br />ALTEHATION ❑ REPAIR '�.- DEMOLITICN I. 1 WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />..nn nuiv I WNTACiPER50NANOPHONENO. <br />�ESCRIBJE fSYORK IND SOUhRE FOOTpG81NVOLVED <br />x �ullq�ll� S�If S� d�� <br />�PROPOSEDUSE BW�OING <br />VYip�-e �- rv�a��.ac�e/'s ��,cF <br />LEGAL DESCliIPT10N OF PROPEflTY �SHOWN BELOW OR AT7ACH <br />�or otocK oc <br />PROJECTFU�RESS <br />� � (p02_ S �. `LU <br />PLUMBING <br />NO. TYPE OF FU <br />WATER CLOSET (TC <br />. BATHTUB <br />LAVATORY�WASH 8 <br />SHOWER <br />KITCHEN SINK & DI; <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />FfiONT SETOACN <br />USEZONE <br />iYPE OF CONST ALIOWABIE <br />SIZE OF BIDG. <br />DCCUPANCVLOAD <br />N �-- <br />REASON FOR SPRINKI.Fne <br />APPtICATiON ACC. FV <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS '. <br />APPLICATIbN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL �. <br />PROVISIONS OF LAWS AND ORDINP.NCES GOVERNING THIS TVP[ OF , <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br />NOT. THE GRANTING OF A PERMIT DOES NOT PflESUME TO GIVE '. <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY �� <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE , <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE ' <br />OWNER Of THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE � <br />CONTFACTORS LAW 1827 RCW AND 296.200 WAC. � <br />SIGNATUREOPCONTRACTORORAUTNORIZEDAGENT OATE � <br />X'�j�1nC�i"�cZ .�-�WJ�Gie; �Li:ere� y✓�a 1 � �rt v1 <br />�PPLICFNTS CITV DUSINE55 LIGENSE 0. AND BUSINESS NAME mq�„v�2r <br />MECHANICAL ` <br />NO. TYPE OF EOUIPMENT FEE <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE 5 ' <br />REAPSETAACK SIDESETBAGK PLAN <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />11NIT HEATERS—B.T.U. M <br />WOOD STO\ <br />IviETAL FIRE <br />FIREPLACE <br />HEATPUMP <br />GAS PIPING <br />FAN <br />LOTAPEA VACANTSITE FEES <br />❑ YES ,-� NO BUiLDING <br />7VPEOFCO�ISi.ACiIIAL �:Cuv�ucv xa ownuiGunrtS <br />T tL. �P PLUMBMG <br />t ' !T +� <br />NO.OFSTORIES BASEMENT MECHANICAL <br />2 (; YES �� NO <br />FIRESPHNKL[RSFEOD NEIGNTLIh11TFT10N OTHER <br />❑ YES �O STATEBUILDINGSURCHARGE <br />STATEENERGVSURCHARGE <br />PLANS�P o oov CITY OF EVERETT PUBLIC WORKS <br />LDCALSALES <br />TAX CODEIS 3105 Tora� <br />8 CHIMNEY <br />SUB TOTAL S <br />PEAMIT $ <br />TOTALFEE S <br />FEE AECEIPiNO. <br />VALUATION <br />