Laserfiche WebLink
...z.,= .a <br /> �...�..�":.t♦ : .__ ." """" �_'_:._�.�._.. . .. .� �- <br />•:�i_:. ._� .�-' . __. .:.� � .�. . ._ . � <br /> � f' <br /> APPLICATION FOR CONSTRUCTI�N PERMIT r� <br /> everett (�' <br /> fM Everpreen � '. <br /> GIN OF <br /> everett � <br /> BUILDING DEPARTMENT TO BE COMPLETED IH INK—PLEASE PRINT <br /> 259-8810 �: <br /> Jd DEMOUTION ❑ COMBINATION �S BUILDING I J MECHANICAL C I PLUMBING ❑ SI6N <br /> (/{�M� M�IL AUDFESS ��TM Z�P PHONE �,� <br /> (J� � ���� CITY ZIP PNONE QD�Z ' <br /> \TEN�Nt MAIL�DOR 5 <br /> � ,4.� A�oa��es �axvn�c /?�?lGiar«,dw N. ��,G�a 9�/01 uac �i�� i <br /> MAILAOUNE55 �RY ZJJJ��� PHONE � �� <br /> �HCHITEGTORUE&IGN ��w //y n�/'/ �(/�`j�a /�/J�� �1 <br /> Orc�N� ��v�,,:-�v ?��s Gu� �'''.S4J -�e.""�!s ,�:,�,.-^ 7 ! V VM/1I Irrr_— ;� <br /> GENENALCOqTN�CTON <br /> MMLADDRESS CIiV ZIP PNONE LICENSE� �'_: <br /> LICENSE� �� <br /> MECH�NIG�LCONTRACTON MMLA�DRE55 <br /> CITY ZIP PHONE �j. <br /> 4s <br /> C�{y 21P PNONE LICENSE� <br /> pW1,IBtl'GGONTHACTOH M�ILADDHESS �. <br /> '4 <br /> C1A550F WORN `^ <br /> ❑ NEW �ADDITION ❑ ALTENATION Cl REPAIR ❑ DEMOUTION CI WOODSTOVE/FRPL INSERT O BUILDING RELOCATION H <br /> CONUGT%eNuOM tND PNONE NO. �'4 <br /> TENANi1MPROVEMENTOflINTERIORREMODELONLY I�I Q� � � <br /> CqlfRACT PRICE OF WORK1 <br /> pESCRIBE WONK I1ND 3W�RE FOOT�GE INVOLVED <br /> / � _ <br /> ax <br /> p EDUSEOFBUILDIN6 Y��o� 4� �ry I HEREBY CEFTIFY THAT I HAVE READ AND E%AMINE� THIS <br /> �� . �?,_,-r.y� d�.� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL �� <br /> / PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF r� <br /> LECALOESCR�PT10170FPR'�ERTYISHOWNBELOWOflATTACNFOURCOPIES� yrORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR it <br /> �or BLOCK oF NOT. THE GfiANTING OF A PERMIT DOES NOT PRESUME TO GIVF. <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV S <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE I�: <br /> PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORIZcO BV THE �: <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STHTE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. �� <br /> SIGNAiUREOFCONTR/.LTOROR�UTHORIEEOAGENT D�TE <br /> X � <br /> � 1._--- ,c <br /> PROJECT�UDflE55 APPLIG�NTS CITY BUSINESS UGENSE NO.�ND USINESS N�ML <br /> Q oADw <br /> MECHRNICAL <br /> PLUMBING <br /> NO. TVPE OF FUITURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ' <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> BATHTUB ' ' <br /> , UNIT HEATERS—B.T.U. M � <br /> LAVATORY(WASH BASIN) � CLOTHES DFYERS ' <br /> SHOWER � ' <br /> KITCHEN SINK 6 DISP � VENTILP.TION FAN � � <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER � � <br /> , WOOD STOVE __� �+,' <br /> CIOTHES WASHER � <br /> � METAL FIREPLACE B CHIMNEY _ � <br /> URINAL , ' <br /> DRINKING FOUNTAIN � FIFEPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> Fi00F DRAINS—RAINLEADERS � EXHAU51�FAN ' <br /> � � <br /> SINK(SERVICE—BAfl,ETC.) � ' <br /> � <br /> � <br /> � <br /> � — <br /> � <br /> � i <br /> —�i— <br /> i <br /> i <br /> SUBTOTAL $ ' <br /> SUB TOTAL $ � pERM1T S � <br /> � <br /> PERMIT $ ' <br /> TOTAL FEE $ ' TOTAL FEE $ ' � <br /> PLANCHcGNNUMBER FEE�`• G� RE^E�PT� <br /> � FPONT6ETBQCN flERRSETQ/CK SI�ESETBADCN D ay37o 7 63 Ff <br /> ( F. <br /> U FEES VALUATION FEE �i <br /> IOTAREA VAC�NTSITE ) <br /> USEZONE ❑ YES ❑ NO <br /> BUILDING . O � G', <br /> occirer�xcr xoauvcum�uxns :, � <br /> TYPEOFLONSi IIOWABIE TYPEOFCON C�LNAL ,pqp Q� pIUMBING �d'b�°� ' � <br /> �N _ iu , <br /> SIZEOFBLDG.^ NO.OFSTORIES B�SEMENT MECH�NICRL � <br /> ' � ❑ YES NO � I <br /> OTHER � <br /> OCCUPANCYLORD FIRESPPNKLERSREOD HEIGHTIIMiTANON �� ' <br /> ! <br /> f ❑ YES �NO U STATEBUILDINGSUflCHARGE i � <br /> NEA50� FOR SPRINKLEflS STATE ENERGY SURCHAfiGE ' � <br /> �,gy PLANSAPP EOBY CITYOFEVERETT PUBLICWORNS � <br /> ,�,: I' LOCAL SALES ; S t <br /> v� TAX CDOEIS 3105 rora� ` <br />