Laserfiche WebLink
APPLICATION FOR t;ONSTRVCTION <br /> PERMIT <br /> rnn c,�m9re�n ,,,.,,,.,, <br /> CITI'OF <br /> everetr e <br /> BUILDING DEPARTMENT <br /> 259-8670 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ,j- n � owr�cn M.n�ooaess u�r nv vnene <br /> � � �a��i�S C�i �9�'y Cd�Ii C.-' �UP�E�� `-l.��d/ o't� a�.�C't-,— . <br /> p b 1CNnNt MAILI�WHESS GrtY 21P PMOHE <br /> Cy y r <br /> nnCnrtEQ RDES�W7NEN M�u�DDeE6S GT1 Z�F RWME <br /> K � S[��} SD�nL dG a-�- - <br /> O S C GCNERALCONiA/�QOR MAILACORE59 GITY 21P F11ONE LIGC .! . <br /> � y ~ �1. /T <br /> y � Q.GnriC O.a� <br /> = VEGM�NIG4GONIR/�GiOR MAILAODtiE95 piY ZP R10ME LIQHS[• <br /> f9 O <br /> y <br /> � VLUMB�N iWGTOH M�ILAODREBS CIiY ZIP PNONE IICCHSf � <br /> � � _ __ <br /> � y � CLh550 WOnN,�� <br /> � ❑ NEV✓ qd ADDItION ❑ ALTERATION ❑ REPAIR ❑ bEMOLIt10V ❑ WOODiTOVfJFRPLINSERT ❑ BUILDINORELOCATION <br /> N a . L.� COMTnGT PERfON AHD GNOHE N0 <br /> Q N iEN�NTIMPHOVEMCNtORIMEPIORREM�DELONIY <br /> fl O N CONTMCiCqiLEOFWORK � S <br /> � � �y DC9CR19EWORN�NDSOVAREf00T�GEINVOLVE� . ��rJ,�{ /�r�f — — <br /> � y l�ee,k��i nm='"-,_..��. -' � �i <br /> y vno�osEouse eui�oiN <br /> I IIEREBY CERTIFV THAT I NAVE READ AND EXAMINED iHIS APPLIC4TION ANO <br /> . C i' KNOW'.HESAMETOBETRUEAIJOCOPFECT.ALLPROVISIONSOFLAWSANO <br /> � � OFDINANCES GOVERNING TNIS TVPE OF WORK WILL BE COMPLETED WITH <br /> �e��toEstaivnOeor BOPEHIVISHOW ee� WONdiTI.CHFDURGONESI WHETHERSPECIFlEDi�EREINORNOLTHEGRAN?IN�OFAPERIdITDOESNOT <br /> �yp� � PRESUME TO GIVE AUiHORITV TO VIOLATE OR CANCEL TNE PROVIStONS O� <br /> ip E'f 7e�OGn ��F ��V ANVOTHERSTHTEORLOCALLFVJREGULATINGCONSTRUCTIONORTNEP[R� <br /> FORMANCE OF CONSTRUCTION.THAT I AM FUTfiORIZED BY TME OWNER CF <br /> TNIS PROPERTV TO PERFORM THL WORH FOF VJNICH APPLICATION IS MADE <br /> AND 1 COMPLY WlTli fl/E 51A1E CONTRFCTORS LAW 1027 RCW AND <br /> 29G200 WAC. <br /> SiGN4ipPkO�CONTR>CiLFOa-Gf��'%Pr.'EDRGC!�i Cn1E <br /> X �0-,.�1 U. /�-i+.��e.�� 5/8/9c <br /> PROJECTLDDRE55 ppcUJ.N�Sf�.iV[U:IryLS IICC�6[NOPqD@Ub.YCiiN<V(� <br /> I 9�"� Co/ �r '✓ �1 . o / <br /> j� � PLUMBING MECHANICAL <br /> I ��_ NO. TYPEOFFIXTUREORITEM FEE NO. iYPEOFE�UIPMENT FEE <br /> WATER CLOSET�iOILET) A/C—A/HNDLG UN ITS—H.P. _ <br /> � . BA7HTU8 FORGEDAIRSVSTEMS—BT.U. MEA _ <br /> LAVATORYpVA5N0A51N� UNITHEATEiiS—BTL. M <br /> ' �w_' SHOWER CLOTNESDRVERS _ <br /> � KITCHEN SINK 6 DISP. VENTILATION FAN <br /> � DISHIYASHER R.ONGE HOOD <br /> � LAUNDRV TiiAV WATER MEATER <br /> LLOTHES WASHER N'OOD STOVE __ <br /> � �� METALFlREPLACEbCMIMNEV <br /> URINAL — <br /> DRINKING FOUNTAIN FIREPLACE INSERT ' <br /> FLOOR DRAIN HEAT PUMP <br /> ' BALKfIOW PREVENTERS _ GAS PIPIN6 <br /> i �r,' POOFDRAINS—RAINLEADERS E%HAUSTFAN _ _ <br /> gINK(SERVICE—BAR,ETCJ <br /> � ' — ___. .. ._ _ <br /> ���' <br /> � <br /> �' . _ SUBTOTAL 5 _ SUBTOTAL S — <br /> 1Iy PEfiM1T 5 PERMIT S <br /> TOTAL FEE S iOTAL FEE S <br /> iAOMSETBPCh � PEARSRBACN SIDES[TPALR PUNCNECItNUM9ER fEE AECEIPTNO, <br /> ��� � Zo� -� _s` Rn au5 7a �o � <br /> use:or+e �oinaE� �A�a�tsi FEES VALUATION FEE <br /> /� rEs Z� <br /> pb'7 .- _— BUIIDING � „ � pp <br /> iYPEOFGONSi. CCGUF�NCYOPOIIP NOOfOWfLLINGUNi15 —��--- -- <br /> qLLOWABtE/ACTUAI//���/ 'A / � � I P�UMBING <br /> ��i /V �1"/ <br /> ;RE Oi BL6i N�O!StORILG �SMf 0..6 LUAU <br /> 5 I n v '. I � MECHPNICAL <br /> z�� � — — <br /> — HEIGHiLIMItq10N OTHEA <br /> riaeSPuiNKtEnSnEowneo ❑vEs � vo �I �S, STATEBUILDINGSURCHARGE ,SYJ <br /> STATE[NERGVSURCHARGE <br /> AP(YiO�M9Y'RLZEf�' PL�NSAPPR 9Y <br /> ..TN IN�� PU�LICV✓ORKS <br /> J <br /> �.}'�11�1 I � � I TOIAL �i 7 S � <br />