Laserfiche WebLink
APPLICATILA FOR CONSTRUCT aON PERMIT <br />CRY0O - <br />CITY <br />everett <br />BUILDING DEPARTMENT <br />259-6810 TO BE COMPLETED IN INK —PLEASE PRINT <br />❑ DEMOLITION COMBINATION [J BUILDING I:: MECHANICAL <br />E✓ClrTykA , <br />PM E <br />'. PLUMBING <br />33 7 —//. <br />OLWFIMCGRMCRIR wtA00 M CITY ZW PICHF LIGRSEL <br />OFG ANY:A: G]NTMC1p1 WEA EW CITY IR ngNE LXENSTA <br />0.U1BN]CCMiRAL1i1P WLAOOREn CITY ZN P11CNE Ir:ERSEI <br />i <br />] SIGN <br />w�ea roRK <br />r/uew rt mnrtlnu �I Y7PRATI41IN "'. REPAII, "! DEMOLITION '.' WOODSTOVFhRPL INSERT :.i BUILDING RELOCATION <br />TENANT YrIgYEMEM 011 WiEREW RE110DEL Y <br />n!IXT mRaYf <br />-- <br />_ <br />CONTACT PERSON MO R R0 <br />OEJCRBE XdY(ANO6WAREfM?AM Nti vrO — <br />�n��r� <br />- <br />— <br />PnoroaEolnFaFeuAoxo <br />1eay`M� <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 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 BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAD. <br />E A%JKUCONT TORORAUTNO111RCAUENr DATE <br />x - I-110-y <br />- �/% <br />Lt. MSCRWT"W ERTY ISMOMq SELGM OR ATTACH FWR CCPIESI <br />LOT &OCN or _ <br />— <br />(�D¢iir <br />-- <br />PflwFciu alEss <br />' <br />APPLI rt LIC <br />I¢Arq HJLLtiSNAMC <br />PLUMBING <br />MEC <br />NICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />I TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC-AMNOLG UNITS-H.P. <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />THINKING FTiUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />_ <br />8ACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />_ <br />EXHAUST FAN <br />SINK (SERVICE" -BAR. ETC.) <br />SUBTOTAL <br />$ <br />SUBTOTAL $ <br />PERMIT <br />f <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE f <br />rTCNT EETBACN <br />,AQUT[IACR <br />sm SETBKA <br />PLAM :N a MIMBEr.�� <br />•''T/ <br />rEE/ ,;2c5 <br />OIVA/LUATION <br />RECEWT� <br />LISE ZGRp <br />I <br />L➢TYx'ANEA— <br />vAGMY S TE <br />!_ YES NO <br />FEES <br />FEE <br />emwlNG <br />PLMiBING <br />_ <br />/� <br />Trn arednl wv.YMle <br />TTPLy (GIT ACTwL <br />ow..a. <br />V <br />.enwTu.cl.M <br />r <br />�O '� F <br />Tq Di eTOREe <br />I <br />oABEMFNT <br />I YES NO <br />MEGIANICAI <br />OTHER <br />OCLUPANCYI¢AO iHiE 6PPTA<lER4 nFQD <br />II YES NO <br />flFASCW rGI6PRNRlFR9 <br />IFpMi IGYIiArCM ( <br />Fi it bT <br />STAIEEWILOINGSURCHAHG' <br />�l�7 <br />STATE ENERGY SURCHARGE <br />_ <br />Am,::ArKY Acc aY <br />PLYq APPRgvEo eY <br />CITYOFEVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />maim WORKS <br />TOTAL <br />�., <br />0 <br />