Laserfiche WebLink
�..� � <br /> F^���� everett <br /> APPLICATIi�rl FOR CONSTRUCI �.ON PERMIT � <br /> ,n�E�e.a��� TO BE COMPLETED IN INK—PLEASE PRINT I <br /> arv oF I <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ /� vH . <br /> BUILDING DEPARTMENT <br /> 259-8810 , <br /> i DEMOLITION I I COMBINATION I I BUILDING U MECNANICAL �PLUMBING f.=] SIGN <br /> pyyN[R MA;ADDRE55 CITY ZIP PNONE2�3 <br /> ,/� r1 q�' / <br /> �7�IU n ,J . /S �Otu/h'� �� Z.7 Jl)'+, r/1 /<'/.�/ri��H !✓�t �t � ]' 9 � ��f S <br /> 1CNANT MAILADDRE55 CITV 21P PHONE <br /> 4RCIIITECtORDE5IGNER M�ILADOFESS CITV IIP PHONE II <br /> GENE��ICONTMpOR M�RADDRE55 CI7V 21P PNOHE LICENSEI �I <br /> MECH�NIGALCON�NACTOR MARAU�RE55 CIiY ZIP PHONE UCENSE� I <br /> �LUMB�GCONiRAC10R MAIIADORE55 diV 21P P110HE UCENSE� �I <br /> CLASS OF WORN <br /> ' I NEW I I ADDITICIJ f l ALTERATION I�I REPAIR I. 1 DEMOLITION I.1 WOODSTOVE/FRPL INSEflT ❑ BUILDING RELOCATtON <br /> CONTACT PEfiSON ANO PHONE N0. <br /> CONTRACT PRK,E OF WONK � <br /> UCSCRIBE WORC AN�SOURRE FOpTAGE IINOIVEU <br /> rn seouseovem�oMa '^ G�s�'�j'e�• I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � z U � � o / �) Q 7� APPUCATION AND KNOW THE SAME TO BE TRUE AND CORPECT.ALl II <br /> LEG�LUESCHIPTIONOFPROPERTY�SNOWN� WS7FATT�CHfWRCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> L � BLOCN �� �O OF �/G. � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> / -/Q - AUThiORITY TO VIOLATE OR CANCEL THE PflOVISIONS OF ANY <br /> 7 OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEH OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WI7H THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> SIGNATURE ClN1TR�CTOROR�UtNOPRE0�0ENi DATE <br /> X <br /> PR E WPE55 � <br /> APPUCRNiS:ITY BUSINE85 LI E NO.AND BUSME55 NMAE <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NU. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � — NC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FOFCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) i — UNIT HEATERS—B.T.U. M i <br /> SHOWER ' CLOTHES DRYERS ' . <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> —�— <br /> DISNWASHER � RANGE HOOD � ! <br /> LAUNDFYTRAY ; WATER HEATEP ; �� <br /> CLOTHES WASH[H � WOODSTOVE � i, <br /> URINAL ' METAL FIflEP CE 8 CHIMNEY ' �� <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i j <br /> FLOOF DRAIN � HEAT PUMP ' ' <br /> BACKFLOW PREVENTERS i GAS PIPING ' <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN � • <br /> SINK(SGRVICE—BAR,ETC.) � � <br /> i � <br /> � <br /> —�— <br /> � � <br /> � <br /> i � <br /> i � <br /> SUB TOTAL S ; -- SUB TOTAL $ ' <br /> PERMIT $ � � PERMIT S � ' <br /> � TOTAL FEE $ ' —� TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: I <br /> FRONTSEiBALK NEARSETOACK SIDESETU�CN PLANCHECKNUMBER FEE RECEIPTNO. '�. <br /> usezor+e IOTRREA VAC�NTSITE FEES VALUATION FEE �'I <br /> i <br /> BUILDING � I <br /> lYPEOFCONIS.RtIOWABIE lYPEOiLON5TRC1U�l atur�H[Y NomvMll�N0lMin — � _ i _ <br /> GqM1° PLUMBINO �� I <br /> SIZEOFOLDl3. NO.OFSTORIES BASEMENT MECHANICAL � I <br /> oCCI�PnNCv LonO FIRE SPRNKLERS AEOD I/EIGIIT LIMILATION ADDITIONAL PLAN CHECH i I, <br /> i <br /> OTHC-N ' <br /> i <br /> RE�50N FOR SPAINRI[PS --� <br /> STATE OUILOING SURCHAFGE i <br /> i <br /> INtAHEBY PUNSAPPROVED6Y CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES <br /> TAX CO�E IS 3105 ror�� � � <br /> �, � <br />