Laserfiche WebLink
_ __ __ —=�rs�� <br /> APPLICATIC -1 FOR CONSTRUCT'-1N PERMIT � <br /> TQ 8E COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: `J GAS ;�ELECTRIC J ----1 I <br /> 259-8810 <br /> I DEMOLITION i COM6INATION i BUILbING MECHANICAL �' PLUMBING SIGN <br /> OWN R lAILqODRE55 GiV ZI^ PHONE <br /> � .���� �n-���,. �,;e��I'f l�l� y��n� �� ` � �� � <br /> i NAN1 MAIIAD RE55 piY ZIP PHONE _ <br /> ARCNITECT OF DESIGNER MAII ADDPE55 GTY jIP PHONE <br /> G[NERAL CONiRA�TOR MAIL ADDRE55 CITY 21P PMONE STATE LIC[NSE� <br /> tA[GHANIGAI CONTRAGTOR Mnli AD�RE55 CITV 21P PHONE STATE LICENSE k <br /> PWIABINGCONiqACTOR MRILADDRE55 CITY ZIP PHONE STRTELICENSEM <br /> CONTqACT PqI�E OF WOHK <br /> occrRlBE W RN S ARE FOO7FGE I LVEO ` CON7ACT PEPSON AND PHONE NO. <br /> _ '✓L / <br /> �`D �Dv f'O�) ���) //rq�e r ',�—� _ <br /> � I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> r oaose us�� uyc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> d ' PROVISIONS OF LAWS AND ORDINANCES GOVEF.NING THIS TYPE OF <br /> ie n�oes�caiarioNOFPao �arr�sNowNeeioaior+n GHTWOCOPIES WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREW OR <br /> ior.�t7_-.ZL�L e�ocK��—`�—. oc �_ NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��[�� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFOPA7ANCE UF CONSTRUCTION.7HAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCELTAKID.NUMBER —' APPLICATION IS MADE AN I COMPLV WITH THE STATE <br /> .� CON�CTOR LAW�8. � CW ND296.200 WAC. <br /> CONSTRUCTION LOAN LENDER.ADOFESS.TELEPHONE NUMBER <br /> PROJECT ADDRESS —" �� <br /> ��a? t,:.,�.��oE �..E <br /> CRYf1lSN[55� . q F4p � <br /> PLUMBING IAECHANICA`L <br /> NO. TYPE OF FIXTUqE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A'C—A%HNDLG UNITS—H.P. ; <br /> BATHTUB FnRCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) �/ UNIT H61TER5—B.T.U. M n� j <br /> SHOWER CLOTHESDRVERS <br /> _ KITCHEN SINK 8 DI.iP ' VENTILATION FAN <br /> DISHVJASHER RANGE HOOD — <br /> LAUNDqY TRAY ; WATER HEATER <br /> CLOTH[S WASHER � WOOU STOVE � — <br /> URINAL ; 61ETAL FIREPLACE(WOOD BURNING� <br /> DRINKING FOUNTAIN FIREPLACE INSEHT <br /> FLOOR DFAIN HEAT PUMP � <br /> BACKFLOW PRE-VENTERS GAS PIPING <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR, ETC.) <br /> i <br /> � � <br /> SUB TOTAL $ ' SUB TOTAL $ ��(� � ' <br /> FERMIT $ � PERMIT $ � <br /> TOTAL FEE 5 TOTAI FEE $ � r+' — <br /> FOR OFFICE USE ONLY: ' <br /> FPOIJTSEiBACK REARSET6ACN SIDESETBACK p�pNl�Ffj�(N4 E FEE REGEIPiNO. <br /> �,��`�0 <br /> usezoNe LOTAREA vnenNrsire FEES VALUATION fEE <br /> ❑ YES G NO BUILDING <br /> iYPEOfCON51 NO.OFSTORIES ottuv�xd HoOroWEwncUYnS <br /> ceoua pLUMBING � <br /> SIIE OF BIDG FlRE SPRINKLEPS REC'0 BRSE vES ^ NO MECMANICAL `/� — <br /> OLGUPANCY LOAD FIRE ALARM pEOD NEIGHT IIMITAT10N ADDITIONAL PLAN CHECK <br /> REASON OTHER � <br /> �— <br /> STATE BUILDMG SURCHARGE ' <br /> RJiqKC Ov ainvsnvcaovEoev CITY OF EVERETT PUBLIC WORKS <br /> I.00AL SALES <br /> on,e TAX CODE IS 3105 TOTAL �_; _ <br /> � � J i <br />