Laserfiche WebLink
IAe Everpreen <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />�iPPLICA('ION FOR CONSTRI,.:T10N <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />O�W.(NJER ( M�IIAUDPE5�5/� s�� "� �O� ,'/ �,.• �/��/)))jQ/�'�.. ��' /�/ <br />/� Y� J ACL�' I 7L(/ ��//L� ._ �" ��� z P—�-- PIIONE i�/.1 <br />hN� T / M�II A�OR[55 <br />�PCNILEGTOPDESIONER MAR�OPPE55 �it� ZiP GIIONE <br />M�II A�ORE55 -�- CItY -..'--'-- 11P "- - PIIONE J IICENSE� <br />OENEPAIGONiR�fTOP --- �----""�� ,,,G/r if�]p�l' �JsGJ� Z2�� <br />�i�%��l�i��.��', _ `f�i .S�'tf��-.��'r---�f -�,�%SU!_�ri YLY (/ PMONE(Y � LICENSE� <br />MEC HIC�LGONTP CTON MMLADORE55 �/��I , [i /�l� <br />��� J� <br />RUM&NOCONTRALIOR M�IIADUNE55 ���Y TiP PIIONE 9 ULENSE <br />❑ ADDITION L� ALTEFA710N ❑ FEPAIR ❑ OEMOLITION coOACWOOgONOAHO/PIRNENOSERT ❑ BUILDINGRELOCRTION <br />VEMENT OR INiERIOiN REMOO�ElL ONLY y���� <br />�l ,�(K ' �--f�s— <br />^.E OF WORIC I <br />LOT BLOCK GF <br />PLUMBINO <br />JO. TYPE OF FIXTURE Ofl <br />WATER CLOSET (TOIL�7) <br />BATHTUB <br />LAVATORV (WASH BASINI <br />3HOWER <br />KITCHEN SINKB DISP. <br />DISHWASMER <br />LAUNDRYTRAY _ <br />CLOTHES WA3HER <br />URINAL __ <br />DRINKINO FOUNTAIN _ <br />PLOOR DRAIN <br />BACKFLOW PREVENTER9 <br />onnc nvewc _ RA W LEA�ER! <br />SUBTOTAL a i <br />PERMIi S <br />TOTALFEE s <br />FRONTSEtBACN PEAHSEiB�GN SIDESEfB�Le <br />/_ ' i <br />USEZONE LOT�RE� VACANTSITE <br />C❑ YES LJ NO <br />� <br />IYPEOFCONST. OLCUPANCYONOVP NOOFLWEIIINGUNiTS <br />ALLOW�BLE/�CTU�L <br />BIZE OF BLDO NO OF SIORIE9 BSMf OCG l OAO <br />❑Y <br />❑ N <br />- -- NEIGNTLIMiT�TiON <br />PRE9PNINNlEfISaEWIFED ❑ YES � NO _ _ ��' __ <br />�PPtIC>TION�CCBY PL�NR�PP�,Y I <br />i�O � <br />��J <br />• U� <br />1 HEFEBY CEFlTIFY 7HAT I HAVE READ AND EaAMINE� THIS APPLICATION ANO <br />HNOW7HESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAW9AND <br />O(iDINANCES GOVERNING THIS NPE OF WOFK WILI BE COMPLETED WITH <br />W HE7HER SPECIFIED HERCIN OR NOT. TNE GRANTING OFA PERMIT DOES NOT <br />PRCSUME TC iIVE AUTHOflITV i0 VIOLA7E OR CANCEL 7HE PROVISIONS OF <br />ANY OTHER S1A7E OR LOCAL LAW AEGULATING CONSTRUCTION OR THE PER• <br />FOFMANCE OF CONSTFUGiION. THAT I AM AUTHORRED BY THE OWIIER OF <br />AND PRCOMPLVTW THRTHE, STATE CONTR CTJORSHLAWL1B2T7�RCWMAND <br />296200 WAC. <br />c�cu� u ncMNiMCtOFk)RI�I1110PREDAGENi D�TE <br />MECHANICAL <br />UNIT <br />PUMP <br />PIPING <br />.G UNITS — HP. <br />iYSTEMS — 9.T. <br />5—BS.U. M <br />VERS <br />FAN <br />PERAiIf <br />TOTAL F <br />BL9LDING _ _ <br />PLUMBING <br />MECNANIC4L <br />OTHER __ <br />STATE 6UILOING SURCHARGE <br />STATE ENERGY SURCIiARGE <br />PUBLIC WORKS <br />TOTAI. <br />U � �v� <br />IESS N�ME <br />i <br />FEE <br />�t EA — <br />f <br />