Laserfiche WebLink
APPLII.ATION FOR CONSTI,J�TION <br /> _ _ PERMIT <br /> fhe Everpreen <br /> CITV OF �'`'''«"« <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259-9870 TO BE COMPLETED IN INK—PLEASE PRINT <br /> !� OWN[R MAItPpO^FE5n5 /� GtY /Z�]�' 1'HONE <br /> r�,� '4 �(/[�IC�!/ ��Yr ��7� 'X / n(c}- 1 �I `� � _ <br /> ���� y TWFN1 MAILpDON[$$ Y IIP PMONE <br /> .�`'��n�� u Lt <br /> C y .ncHirEcrono�� Maa.00aess cnr ziv vnor�E <br /> �� � <br /> h] M GENENRLCONTRAGTOP MIIILADOPE55 LITY IIP PMONE L�GENSE• <br /> K A <br /> H 7tl <br /> �N � M[CNAHiGALCONTPAGTOR MML��OPESS G�tY ZIP PHOHE L1LENiE• <br /> fA N F .S'J�,r7�� .S�/C'fT//�l)1[ S4// � ZK �Zu/ S73/i4 <br /> ���III �,,�.,� L _��r 7 c�-�r-�--k��z� <br /> y� � PWM NOCONiRACTOR M�IL�DORESS CILY ZIP PNONE LIGENSE• <br /> [ <br /> d <br /> OM �j CUSSOfYARN <br /> �� Q ❑ NEW ❑ ADDITION ALTEHATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVFJFRpLINSERT ❑ BIIILDINGRELOCATION <br /> G]• C� 1£N�NtIMPRWEMENtOFINtERIOFNEMOOEIONLY COHiAAKR50N�NOPHONENO. <br /> �y� CONTP�GT PRICE OF WORK <br /> DCSCRIBE WOHK AND SO W PE i00iAGE INVOLV[0 <br /> H y - y��!t! <br /> ��p.� vqorosE0u5EOFeuaowo IHEREBYCERTIFYTHATIMAVEREAOANDE%AMMEOTHISAPPUCATIONAND <br /> �� N �[// KNOW?HESMdETOBETRUEANOCORRECT.AILPROVISION50FLAW5AND <br /> iecnl OESCFIF➢ON OF VqOFEflTYIBNONN BELOW ON ARALN FOIIN CAPIE51 ORDINANCES GOVERNING THIS ttPE OF WOFK WILL BE COMPLE7ED WItH <br /> W HETHER SPECIFIED HEREIN OR NOT.TNE GRANTI NG OFA PERMIT DOES NOT <br /> PRESUM E TO GIVE FUTHOFIiV TO VIOI.PT[OR CANCEI THE PROVISiONS OF <br /> y� � �oT B�oCK oF ANYOTHHRSTATEORIOCALIAWREGULATINGCCNSTRUCTIONORTNEPER� <br /> FOi�MANCE OF CONSTRUCTION TNAT I AM AUiHORIZEO BV THE 01YNER OF <br /> � THIS PROPEFTV TO PERFORM THE WOf7K FOR 1NHICH APPLICATION IS MAOE <br /> , AND I COMPIY WITH TNE STATH CONTRACTORS LAW 1827 RCW AND <br /> � 296200 WAC. <br /> 61pNAiUREGFLONiRRGiGROF4��i110PIZCOFGRII URtE <br /> X ,�...�� � �� `�-zs-�9 <br /> PROJ[GT AODR[35 qPPLICl.NTS LIiY BOSINC55 LIGENSE NO RNU BUSINES$NaN[ <br /> ?7ZZ � h <br /> PLUMBINu MECHANICAL <br /> " NO. TYPEOFFI%NflEOHITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILEp NC-A/HNDLG UNITS-N.P. <br /> 1�I BATHTUB FORCEDAIPSYSiEMS-B.T.U. MEA <br /> LAVATORVIWASHBASIM UNITHEATERS-B.TU. M <br /> ' 1 SHOWER _ CLOTHESORVEFS <br /> KITGHEN SINKB�ISP. VENTILAiION FAN <br /> '�� DISHWASH[R RANGE HOOD <br /> '�t LAUNDRV TFAY \YATER MEATER — <br /> CLO7NE5 WASHER �'✓OOD STOVE <br /> URINAL METAL FIREPLACE B CMIMNEV <br /> ��' DRINhING FOUNTAIN FIREPLACE INSERT <br /> �1 FLOOR ORAIN �j HEAT PUIdPS _ <br /> BACKF�OW PREVENTEHS GAS PIPING <br /> �' ROOF ORAINS-RAINLEADERS E%hAUST FAN <br /> � SINK(SEFVICE-BAR,ETC� <br /> 1�' — <br /> '! _ _ <br /> I � SUBTOTAL S SUBTOTAL $ — <br /> ' PERMIT S PERMIT S <br /> � TOTALFEE S TOiALFEE S <br /> -- fRONL5EIB4Ch PEAHS[TBFCN SIDESEIBALN PtANLNECRHUMBEN FEE PECEIPINO. <br /> usezorve tOt�aee vec�HiSitE FEES VALUATION FEE <br /> a rEs n Ho <br /> TYPEOFCONST OCWPANGYOROUP NOOFOWELIINOUNrtS BUILDING - _ <br /> ALLOW�BIFI�CTU�L PLUM0ING <br /> S�ZEOFBLDG. rvOAFSTORIE8 &SMi. OCGLO�D � , <br /> ❑y MECHANICAL <br /> ❑N — <br /> HEIGNiLIMIT�TION OTIIER <br /> naE6rPINNLERSeEOV�RED ❑YES ❑HO STATE BUILOING SURCHARGE <br /> STATE ENERGV SURCHARGE <br /> �FPIIGAIIUNPGGBY PLANSI�PPF.BY <br /> PUBLIC WORKS <br /> ��� TOTAL �� � <br />