Laserfiche WebLink
APPLICATIOI _ FOR CONSTRUCTI..N PERMI�f' �����" <br /> ��t,�ro„e„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CItV OF <br /> everett RTMENT I HEATING SYSTEM: ❑GAS ❑ELE(:TRIC O__ _—j <br /> 259-8810 <br /> I I DEMOLITION I_7 COMBINATION �BUILDING I I MECHANICAL I 1 PLUMBING I I SIGN ' <br /> OWNER M�ILAOORESS ITY 21P PHONE <br /> TN� BO��N6 Go. R o• U'oX 37o7i lu�s�K'7� SGM-rR.E�Wi�. 3�2—r�'�P <br /> TENANT M�ILADOflESS CITY 21P PHONE <br /> SA-r.,+c AS owNEN <br /> �flCNITECTOR0ESI6NEfl MAIL�UDPESS CITY 21P PIIONE <br /> "i71-E A-�ST�N Go. <br /> OENERALGONTfl�CTOR M�KAOORESS GITY 21P P110NE UCENSE• • <br /> T�'� fWSTiu Gd. (lol.r-'f7� F}-VE. �N, EV�2�� G✓A-. ?1Jo�9/72 A��ST/C�377�'3 <br /> MECNANICALCONTMCTON AUDRESS C�lY ZIP PHONE LICENSF.� <br /> PLUMBWOLONTRACiOR GAILAUDHESS CITY ZIP PIIONE IILENSEI <br /> CIASS OF WONK <br /> ,f,�NEW ❑ AODI?ION ❑ ALTERATION ❑ REPAIR f 1 DEMOLITION I l WOODSTOVE/FRPL INSERT 17 BU�LUING REIOCATION <br /> CONUCT PERSdI AN�PIqNE NO <br /> CONTRACTPNICEOFW�7fIK aa 33S oo� LE-un•rtiD fF's7-L�m�3a�5rJ zt�-3r6� <br /> DESCflIBE WORN�HD SWAPE F00T�6E INVOLVE� <br /> I�-0 ood SF / <br /> rnoroseouseaveunoir�o I HEREBY CERTIFY THAT I H VE READ AND EXAMINED THIS <br /> fS'IR.r'�e.w�FT A�SSd>+'�3L APPLICATION AND KNOW THE SAME TO BE TRUE HND COflRECT.ALL <br /> LEOALOESLHIPTIONOFPflOPERTY�5NOW118ElOWORATi�LNFWflGOP1E5� PHOVISIONSOFLAWSANDORDINANCESGOVERNIN�THISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OFi <br /> ioT e�oc" °F NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTNER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH <br /> APPLICATION IS MADE AND I COMPLY 1YITIi TI1L STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> fiK.N�TUREOFCONfMCTORORAUTNORREDAOENT DRE <br /> PRQIECTiNORE54 n ^ p / �C, "� "- ""�' `��//�//y _ <br /> �QO3 W� C/)S/NO /�l ^ p O��1� �P��ANTSdTYBUSM LICENSENO.NIUBUSMESSNAME <br /> PLUMBINf3 MECHANICAL , <br /> NO. TYPE OF flXTUNE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—AIHNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DflYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER i WOODSTOVE i <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> ORINKING FOUNTAIN i FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; dAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN � <br /> SINK(SERVICE—BAR.ETC.) ' <br /> � 1 <br /> � <br /> � � <br /> � <br /> � � <br /> SUB TOTAL S � SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTALPEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FIIONTSET CN flE�flSET N SIDESEIB CN PlAHC11ECNNUMBER FEE RECEiP�NO. <br /> A � n a �f 3 5'� f/ -z -4. <br /> USEZplE �orene� VAC�Ni51TE FEES VALUATfON FEE <br /> _Z � ro )UILDIN6 Bz �, � � ; <br /> ITPIOiCIN1tSAll ABIF TYPEOf OHSIACI acC�vuK�' NoaUW[lUxtwis JO'� � <br /> / GRP12 _ _ PLIIMBIN6 �_ <br /> � <br /> � <br /> 51ZEOFBl00. NO.OFSToflIEs B�SEMENi MECH�NIC�L � <br /> �a� a��- �C <br /> OCCUANCVl0�0 FIRESPPNNLEf19RE0D NEIOHTLIMIT�i}ON ���P�AMCHECH � � ��p <br />� s� yEs -� ,�, - � <br /> i OTHER _ i <br /> RE�SONF flSPRINNlEflS --�— <br />� STATE OUILDING SURCHFRGE t�I i � <br /> IIIi�NCBV PUNSA f�OVE00Y CITYOFEVERE7T PUOLICWORNS � <br /> /h LOCAL SALES <br /> i �� TAl(CODE IS 3105 rora �y�o„6"�8 J <br />