Laserfiche WebLink
APPLICATI�N FOR CONSTRUCI �Ol�ii PERMIT <br />everett <br />rne Ere,g,een � <br />CIN OF <br />everett <br />BUILDlNG DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259•8E10 <br />i I DEMOLITION I I COMBINATION i I BUILDING I I MECHANICAL I I PLUMBING i I SIGN <br />ONTlER AIAl1.A0DOBS5 QTY IIP PIIONE <br />� .��` C � _ � �t'• .i�i.�-.SS % <br /><�.�«hP r/ldi- ,.y . r - •�!t- &- i � <br />TENANT � MAllA00RES5 QTY 21P PIIONE <br />AflCHITEGTORUE5IGNER I.I�ILADDRE55 QTY ZIP PHONE <br />GENEFAICONTRAGTOfi MpILADDHE55 ��t1' 21P PHONE LICENSE/ <br />. , �, n._ �,_i.., %i<i ��% `i�Zyo ✓"6y-/i5i Sa��.(.��/.�r.Ar. <br />MECNRNICN.CONTR�CTOR MAILADORE55 LITY ZIP PNONE LICENSEt <br />PLUMBINGCONTRACTOR MAILA�ORE55 LITY ZIP PIIONE IILENSE� <br />i / <br />y� i ~n r/��!/�r/�' C�%P ! l�r Sua� t/ I:�ZyU <br />CU55OF WORK / <br />I I NEW I(�f ADDITION I I ALTERAT�ON I I REPAIR I I DEMOLITION I I WOODSTOVFJFRPL INSERT I I BUILDING RELOCATION <br />IENANT IMPROVEAIENT Ofl WTGOIOO I1GMOf1E1.ON1Y <br />CONTRACT PRIGE OF WOPN: <br />OESCRIBE WORN �ND SW RNE FOOTAGE INVOIVED <br />x ��c�, n /�r <br />PBOPOSEO USE OF BUILOING <br />� f�� �.x.� /�.�.�/y <br />IEG�L DESCPIPTION OF PROPERTY �SNOWN OELOW ( <br />l0T BLOCK OF _ <br />rnaecr �ooaess <br />�' 9/6 �i�, <br />PLUMBING <br />NO. T' <br />WATER C <br />BATHTUB <br />LAVATOR' <br />SHOWER <br />KITCHEN <br />CLOTHES <br />UFINAL <br />DPINKING <br />FLOOR DF <br />BACKFLOI <br />ROOF DRI <br />FRONTSETBRLN <br />lISE 20NE <br />IYPE OF CONSi AlIOWABIE <br />SRE OF OIDG. <br />OCGIIPANCYLOAD <br />REASON FOR SPRINKLERS <br />APPIICATION ACC. �Y <br />roun cories� <br />CON7AGT PEfI50N RNO PII(k!E NO. <br />I IIEREBY CERTIFY THAT I I1AVE READ AND EXAMINEo lfii5 <br />APPI.ICATION AND KNOW THE SAME TO BE TRL1E AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITIi WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRA�ITING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <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 1027 RCW AND 296200 WAC. <br />SIGN�TUREOFCONTRALTOROP�UiNONIZEOAGENT D�TE <br />X Soa� .,.0 C/ ' '� i%lFi S' <br />APPLICANTS QTY BUSINE55lILENSE NO. AN� BUSINE55 N�ME <br />mc <br />N0. <br />FORCED AIR : <br />UNIT HEATER; <br />CLOTHES ORY <br />VENTILATION I <br />RANGEHOOD <br />WATER FIEATE <br />WOOD STOVE <br />METAL FIREPL <br />FIREPLACE IN <br />HEAT PUMP <br />SUB TOTAL $ . '� 7 �' � _ <br />PERMIT $ � <br />TOTALFEE $ ��� " � <br />RERRSETBRCN SI�ESETBpCN PLANd1ELN11UM�Efl <br />LOTMEA VACRNTSITE FEES <br />� ES I I NO <br />� I Y (3111LDING <br />IYP[OfC0tI5fACI11AL a��iNHtr NaaoWlwNGiNuls � --- <br />4P°°P PlUMOING <br />NO.OFSTORI@5 BASEMENT �,�EGHANICAL <br />I I YES I I NO <br />FIFlESPRNKIEASPEOD HEIGNTIIMIIRTION �7HER <br />I I YES I I NO STAIE BUILDING SURCHppGE <br />STATEENERGYSURCHARGE <br />PLANSRPPROVEDOY CITY OP EVERETT PUOI.IC WONHS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />8 <br />FEE <br />M <br />M E.A. <br />S��,. _ ; ._. <br />$ �i�'a �_ <br />g ��i <br />PELEIPT NO. <br />1� 1 � . <br />-.i li .. <br />