Laserfiche WebLink
� <br /> ,: <br /> d�PPLICAT10i�F01� CONS�RUCT1�1 P@RMI'T eVef°''� ', _ <br /> i �� <br /> ,,, E „n ,,� TO BE COMPLETED IIJ INK—PLEASE PRIM1lT " <br /> _ • ,.. <br /> �' � <br /> CITY OF �_. 1-� <br /> everet# -� ��� <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ s� <br /> BUILDING DEPARTMENT <br /> 259-8810 �� <br /> DEMOLITION COMBINATION }CBUILDING J MECHANICAL PLUMBING Slc: ' y <br /> O1YNER MFIL ADOR-GS <br /> GI7V 21P PHONE � <br /> J�/�j/ W.� �n.c,rf !_L�/ //s� f�,i��r�f 9P2o/ o2s?6G1z <br /> "`� CIN ZIP PMC'IE �, <br /> iE/W'�N)T MAILADDRESS <br /> �����'�/{-�(_��.,..in ��n�c%�/57a H/s� ���i�� �% P�.zc�/ ��36'.3� � <br /> �g`�q��/' It— MAILADDRESS // CITV ZIP PHONE <br /> ,���fY- ��S7�s�C� /JZrr � Gi��� !� <br /> ❑BJLAALCCNTRPCTOR lAARAODRESS CITY ZIP PHONE LICENSEN <br /> ��A/D�IT - ;" <br /> lAECHaNICAL GONTRACTOR MAIL ADORE55 CITY 21P PMONE UCENSE M b <br /> P- <br /> PwN31NGCONTRAC70R AIAILA�DFESS CI:V ZIP PIIONE LICENSEa i� <br /> I <br /> CLASSOFWORK �G � <br /> � �. NEW xAD ION ' � ALTERATION �. REPAIR . �' DEMOLITION �. �. WOODSTOVE/FRPLINSERT r: BWLDINGRELOCAIiC���': � <br /> /l���� �� �q✓�� � YU CONTACT PERSON ANO PHONE NO. � <br /> !/ I <br /> GONTRACT PRIfE OF WOFK - �, <br /> DESGRIB WORHANDSOUAREFOOTAGEINVOLVED � <br /> �ec/r b' ' X �� � � y .rF_� <br /> PROPOSEOUSEOFBUILU�NG I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED Tf;i� <br /> �L.� � �,_ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> L[64L DESCRIPTION OF PROPERTV ISHOWN DELOW OR ARACM FOUF COPIcS) ^ A PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �/ / S !1 /6 WORK WILL BE COMPLETED WITH WHETHEFl SPECIF;ED HEREIN OR <br /> lpi � BLOCK �_ OF ✓�IGLy- r RQ,��� NOT. THE GRANTING OF A PERMIT DOES NOT PFFSUME TO GI`.'P a <br /> a—(�1 AUTHORIT'f TO VIOLATE OR CANCEL THE PROVISIONS OF A�:'� �,T� <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTIOW OR �i�!IL <br /> PEFlFORh1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY i���;:--: I <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FC�? �'Ji;b .'�I <br /> — APPLICATION IS MADE AND I COMPLY WITH THI: . .. . ;��' <br /> CONTRACTORS LAW 78.27 R7W AND 296.200 WAC. M., <br /> SIJNATURE OF CO TR�TOR OR AUTHOFIZED GENT ATE <br /> J /���(, , <br /> i/,/3���t,� X .�` c <br /> PFOJECTADDRE55 � p —-�—- — �t.. <br /> I S /O �/� �f� /G'f"/ '�" / CJ APPLICANTS CITY BUSME55 LICENSE NO.AND BUSMe55 NAME �y <br /> PLUMBING MECHANICAL ,. <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—NHNOLG UNITS—H.P. <br /> 6:.7HTU8 FORCED AIR SYSTEMS—B T.U. M E.A. <br /> LAVATORY(WASH BASIN)� � _ UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHVJASHER � RANGE HOOD _ . <br /> LAUNURY TRAY � ; WATER HEATER � <br /> i <br /> CLO�IicSWASHER � WOODSTOVE _ I,� <br /> URINAL ; MEiAI.FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRA!N ' HEAT PUMP _ . . � <br /> BACKFLOW PREVENTERS ; GAS PIPING _ . � <br /> ROOF DRAINS—RAINLFADERS EXHAUST FAN . i�� <br /> SINK(SERVICE—BAR,ETC.) ;- � <br /> � <br /> — '1 <br /> SUB TOTAL S ; SUB TOTAL 5 ' <br /> PERMIT S PERMIT S � <br /> TOTAL FEE S TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: -- � <br /> FRONTSETBACN REARSETB�CK SIOESETBACK PLANCH CKNUld�EP FEE RECEIPTHO <br /> p' i o ' �.,' . ��zo-� � �/a• 9� vs �� <br /> USEZONE ioTnr�en VACANT�SIT(�E FEES �VALUATION FEE �. <br /> � Z /�/�% BUILDING J�7 (J �i%.3 ' . _ '� <br /> iVPEOfCONiSAIIOWABLE lYPEOiCONSTALTUAI nCCuvu�n HOofCwFuiuGuxiiS } <br /> V _ j caouv PLUMBING _ <br /> 'V v— /� � <br /> SIZE OF BIDG. NO.CF STORIES BASEIAENT !�.�=CHANIGAL � <br /> so� Sa.=T.oEcK -- <br /> OGCUPANCYLOAO FIRESPRNNLERSREO'D HEIGHT�IMR�TION ADDITIONALPLANCHECK __ <br /> u ��u O7HER <br /> REASON FOR SPRINKLEFS <br /> STATE BUILDING SURCHARG� �� <br /> INTAK[PY PLANBAPPROVEDBY CITYOFEVERETT PUBLICWORKS / <br /> { h,, LOCALSALES � <br /> j� ►jl TAXCODCIS31O5 TOTAL _ ��'✓_ <br /> k <br /> ---. � �-..y :--.� <br /> - -. �r-.:T..,._— :�..- <br /> � _�.� <br />