Laserfiche WebLink
U �-7B-S <br /> APPLICATIC _J FOR CONSTRUC7 . JN PERMIT �, <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT' `�;.�,+�,r <br /> �J_.. <br /> RUILDING DEPAATMENT HEATING SYSTEM: U GAS f�ELECTFIC U --� <br /> zss-eA i e <br /> DEMOLITION COMBINATION �( qUILDING MECHANICAL PLUMBING SIGN <br /> OWNER M�II�OORE55 � CITV 21P PHON[ <br /> G�ATH�Oowc�l l 2G:?S /39 i� S r Ev qb-�,s� 3�1- '�7,� li <br /> TEN�NT MAILAODRE55 CITV 21P PHONE <br /> �RCNRECTORDESIONCR IA�ILAOLRE55 LITY Z!P PHONE <br /> GENER�LCONTR�CTOR M�IIADORE55 �y CITV 21P PNONE SfATEIICEN3E• <br /> �oLeN a�zN, 36�a- q� '" �f� S•� f.�-"Y. Y�'7bt 33J-3Y��) Gaa�nMd���Jl� <br /> MECH�NICAICONTN�CTOR M�IL�DURE55 CIiV 21P PIqNE SiRCIIGEN5E1 <br /> PLUMBINO CONTPACTOR M�IL�ODRE55 CIiV 2iP PNONE STATE LICENSE I <br /> ClASSOFWONN -- — <br /> �( NEW ADDITION ALTERATION FEFAIF DEMOLITION WOODSTOVEiFfiPL iNSERT BUILDING RELOCATION <br /> � �� CONTACT PERSON RND PFON=NO <br /> CONiR�LT PFICE OF WORN 3S�O Cy <br /> DIE.SC�PIBE WORN�ND SOURRE FOOT GE INVOLVEO� ) '—' <br /> M�fr ffol4�c �OD� .dit/9� � � <br /> PROPOSEO USE OF BUIlDINO V — --- -- <br /> I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND HNOW 7HE S.',ME TO BE TRUE AND CORRECT.ALL <br /> lE6�L�ESGRIPTIONOFPROPERTv�SMOWNBELOWORAiTACHFOURCOPIES� PROVISIONSOFLAWSANDORDINAWCESGOVEFNINGTHISTVPEOF <br /> WORK WILL BE COM1IPLETED WITH WHETIiER SPECIFIED HEREIN OR <br /> �or�_ BLOCN O: NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> N3 F oT"' � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> L� � `T OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 7ii[ <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED�Y 7H[ <br /> �j .�+-VpI�I 1 I� S OWNEP OF 1HIS PROPERTY TO PERFORM THE WOPK FOR WHICH <br /> APPLICATION IS MADE AND I CO'.iPLV WITH THE STATE <br /> C'O��_(I/ CONTRACTORS LAW iB27 RCW AND 296200 WAC. <br /> _ �/ <br /> (nlo I(v � Cc,� /v /ls/ x � Q.�.� �L tr 9` — <br /> PPQIECT DDRESS s�cw��unt �' p�q � <br /> UivqpSNt551�CEN5E NO <br /> PI.!1MBIN� MECHANICAL <br /> NO. TVPE OF FI%TURE OR I7EM FEE NO. TVPE QF EOUIPMENT EE <br /> WATER CLOSET(TOILET) 0.�C-A�HNDLG UNITS-N P. � � <br /> BATHTUB FORCED Alfl SVSTEMS-B.T.U. id E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY ' WATER HEATER <br /> CLOTHES WASHER WOOD STOVE / � <br /> URINAL METAL FIREPLACE 8 CHIMNE - <br /> DRINKING FOUNTAIN FIREPLACE INSERT / � <br /> FICC:' �RAIN HEAT PUMP <br /> BACY.. LOW PREVEN RS ; GAS PIPING � � � <br /> ROOF DRAINS-R LEADERS EXHAUS?FAN <br /> SINK(SERVICE AR,ETC.) � <br /> —�-- <br /> T <br /> _ SUB TOTAI. $ ' ;iUB TOTAL $ <br /> PERMIT ) --r FERMIT a i <br /> TOTAL FEE 3 TOTAL FEE $ <br /> FOR OFFICE USE ONLY: "( <br /> FRONTSETB�CN RE�RSF.TBACN SIDESETI`hCK J ANLHECKNUMPF.R FE qECEIPiNO <br /> � �' �a► 3� �.�� 3�� -�y�� <br /> �'SEION _� iov,nee yAC�ytsrte J Y FEES VALUATION FEE <br /> Y BtiILLING G bs �� <br /> IYPE 0!LONIS�ILOW�Btk IYPf Of CONSi ALIU0. octc>eNtr Na a owmMc uNrts � <br /> �_N _ �.� � ,� ( PLUMBING <br /> SIZE OF BlD(3 NO OF STORIES BASEMENT MECNANICAL 1— <br /> Iti SFr � _ <br /> II �H:CUP�NCY LOAD FlqE SPRNNlEPS REO'D h EIGH7 LIMIT�iION ADDITIONAL PLAN CHCCK i <br />� _.�J� �� ' - �,q _ _= <br /> REASON FOR SPRINNLERS � � �t�_ � �[�_:( ' J G � <br /> �(' . � vt' ,/�- /Q.� SiATE BUILDING SURC�IARGE 'i Z� <br /> r. i <br /> INT�KE BY Pl/�N5�PPROVEO BY TY OF EVERE7T PUBLIC WONKS �� / <br /> LOCAL SALES � <br /> J�� A � tiL TAK CODE IS 3105 TOTAI. � ; . <br />