Laserfiche WebLink
APPLICATIC l FOR CONSTRI�CT )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASk3 PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS ]ELEC7RIC ❑ <br /> 259-6810 <br /> DEMOUTION COMBINAT70N BUILDING MECHANICAL PLUMBING SIGN <br /> OYMER MAIL ADDRE55 GTv IIP PMONE <br /> Et+erett Theater Society 2911 Colbv Ave. �erett 98 f17 06-258-6%6 <br /> iEN�NT M�IL ADDRESS CT' IIP p�p <br /> ARCNRECT OR DESIGNER MAIL qDDRE55 GTV ZIP PMpNE <br /> GENERAL CONTRRCTpR MAIL AODFE55 GRV IIP PHONE STQE LICENSE I <br /> Bosler EnerRy Systems 14211 N.E. 193rd P1. Woodinville 98072 206-481-4747 BOSLEES088CL <br /> MBGHANICAt CONTPq�10R Mhll AODR[55 CITV ZIP GHONE ST�TE LICENSE I <br /> PLUMBMG CONTRpCTOR MAIL ADDBE55 GRV IIP PHpNE STATE LICENSE� <br /> GUSSOF WORR <br /> - NEW ADDITION . ALTERATION REPAIR � DEIAOLITION WUODSTOVFJFRPL INSERT BUILDING RELOCATION <br /> CONTAGT PERSON AND P40NE NO. <br /> corrra�cr�A�ceoFwoa� $1,200.00 Kirk I�hmn Bosler Fner S stetns 206-481-4747 <br /> DESCRIBE WORK RND SOURqE FOOTAGE INVOLVED <br /> Gas piping 100 linear ft. <br /> PPOPOSEDUSEOFBUILDIN3 i HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNUW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCPIPTIpNOF PROPERTVISHOWN BELOW OF FTiRCHFOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT e�ocK oF N07. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVIS�ONS OF ANY <br /> OTHER STATE OR LOCAL UW REGULATING CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEA OF THIS PFOPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT TORS LAW 1827 HCW AND 296200 WAC. <br /> x �S -I-r <br /> PHQIE/C�T/AD]DRE55 L 5 oe*E <br /> L� / // _�i/ /JV R .USMfSSI�ffNS[Np <br /> PLUMSINO � CHANICAI <br /> NO. TYPE OF FlXTURE OR ITEM 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(VJASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHES DRYERS <br /> K�TCHEN SINK 8 DISP VENTILAT�ON FAN ; <br /> DISHWASHER RANGG HOOD � <br /> LAUNDRY TfiAV ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL ' METAL FIREPV+CE 8 CHIMNEV <br /> DRINKING FOUNTAIN I FIREPLACE INSERT ; <br /> FLOOR DRP,IN � HEAT PUMP � <br /> � <br /> BACKFLOW PREVENTERS GAS PIPING 4O ;OO <br /> ROOF DkAINS--RAINLEADERS EXHAUST FAN � � <br /> SINK(SERVICE—BAR, ETC.) ; � <br /> � ' <br /> � , <br /> � ; <br /> SUB TOTAL $ ; SUB TOTAL S O 'UO <br /> PERMIT $ � PERMIT S IS �OO <br /> TOTALFEE $ ' TOTALFEE $ SS 'OO <br /> FOR OFFlCE USE ONLY: <br /> FPONT SETBRCK REAP StTBRLN SIDE SEIOACN PLAN GHEGK NUMBER FEE RECEIPT NO. <br /> USE ZONE �oT nAen vacnNr srte FEES VALUATON FEE <br /> dUIIDING i <br /> TYPEOFCONiSALLOWABL[ TYP[OFCONSi.ALTUAL octuMrtt xOAowfuixGUvrts 1- <br /> GPOU> � <br /> PLUMBING <br /> i <br /> SIZEOFBLO(3. NOAFSTORIES BASEMENT MECHANICAL � <br /> OCGUPANGV�OAp FlRESPqNKLEF5FE00 HEIGNTLIMp�TIpN AUDIiiONALPLAI'1CHECK <br /> SPRINKLER � <br /> FEASON FOR SPRINKLERS � <br /> STATE BUILDING SURCHARGE � <br /> � <br /> INT�KE BI PLANS�PPROVEO BV CITY OF EVERETT PUBLIC WOPKS � <br /> LOCAL SALES <br /> TAX CODE IS 3105 ror�� � <br />