Laserfiche WebLink
fhe Everpreen <br />CITY OF <br />ever�tt <br />BUILDING UEPAFTMENT <br />259-8810 <br />t� r� <br />APPLICAT�ON FOR G'ONSTRvCT10N <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />5ll <br />C\'CfCtl <br />e <br />5Nc o � •,.q�f.29p .�.,ry� 56$= IR � �j <br />GITY ZIP PNONE <br />`) ii 11'1 G _ <br />RRCNITECTORDESiGNER MARADORE55 Giiv ZIP PnONE <br />STRUCTu2/�c. ci�TE �Po P�o�3�� �YuN�000�9�S_0_�� <br />OENERGIGONTRACTOR �LRDORE55 CiTY ZIP PNONE IILENSE• <br />Co82R �o►�ST� o go�- 12�a ��pnp,�b( �r���5��� co�g�c�2 08 <br />MECN�NIWLCONTRAGTON M�IL�DDRE55 GLY 21P VHONE L6ENSE• <br />PLUMBiN6CONTR�GTOR MAILpDDRE35 CIiV 21P P')iE licf.NSE• <br />�NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLIiInN ❑ WOODSTOVEJFRPIINSERT ❑ BUILDINGP[LOCATION <br />TEN�NT IMPROVEMENI OR IMEFipR REMODEI ONIV . CONiACT PEFSON ANO PHONE NO. <br />CONTPICT PRICE OF WORK �D� O( %�' / D� C..� �;� <br />LOT BLOCK_._ OF <br />PLUMOINC <br />TYPE OF <br />WATER CLOSET Ri <br />LAUNDRViRAV <br />fLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />ROOF DRAINS — I <br />ewv ieeo�nr[ _ <br />TOTAL <br />FEE <br />I HEREBV CERTIFY i I IAT I HAVE READ AND E%AMIN ED THIS APPLICATION ANU <br />KNOW THE SAM E TO BE TR�JE AND COR(7ECT. ALL PROVISIONS OF LAWS AND <br />ORDINANGES GOVERNING THIS TVPE OF WORK WIL� 6E COAIPLETED WITH <br />Wl1ETH[R SPECI FIF.D HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESU ME 70 GIVE AU7HOPI?Y TO VIOLA7E OR CANCEL THE PROVISIONS OF <br />AN V OTH�R STA7E OR I.00AL LAW REGULATING CONS7RUCT;ON OR THE PLR� <br />FORMANCE OF CONSTRUCTION. THAT I AM AU7HORIZED BV THE OWNER OF <br />THIS PROF�ERN 70 PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY 'JJITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAC. <br />smr+nruacorconranr.roFOHnu*NoaizconeenT onre <br />X ��` <br />APPLIC/•NTSLI BU ME55 ENSENOANpBU5WE55NAME <br />MECHANICAL <br />NO. TVPE OF EOUIPME <br />A/C — A/HNOLG UNITS — H.P. <br />FORCED AIR SVSTEMS— B.TU. <br />UNIT HEATERS— B.T.U. M <br />CLOTHESDRYERS <br />VENTiLAT10N FAN <br />METAL FIREPLACE! <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />g SUB TOTAL <br />g PERMIT <br />g TO7AL FEE <br />IDESETBAGN PIANCN CKNUMBEP FEE,�, , ^ <br />� %a2�1 S' „�� � <br />�«� <br />�l n rss l�o <br />C� <br />fVFE OF CANST. OCCUPFNGYGNOUP NO OP �WELLING <br />ALLOW�BIEACTU�L' � '� <br />a- z <br />512[ OF OLDG. NO. OF STORI[S OSMi, qCG LOAD <br />Z7-1� �N Z�� <br />HEIGMT LIMITATIO <br />Fip[SPPINNLERSREOUIRED ❑ VES d�10 <br />PPPLIG4TIONACC DY PLANSAPPR BY <br />_�� � <br />FEES <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHEP <br />STATE BUIl01NG SURCHARGE <br />STATC ENERGY SURCHARGE <br />PUBLIC WORKS ' <br />TOTAl <br />Fee <br />1 <br />FEE <br />