Laserfiche WebLink
� ; <br /> APPLIC1gcf10N FOR CONSTR�TION <br /> 3 PERMIT <br /> 1 fhe Enrynen � <br /> '� CITYOF <br /> � everett everett <br /> � BUILDING DEPAqTMENT � '�. <br /> 259•8870 TO BE COMPLETED IN INiC— PLEASE PRINT <br /> : ONNER AUILApDNE55 GrtY ZiP IMONE <br /> ; �• GL.�/2.L e J/�i��- 7�OG�3S� F�T'�—��� -�'s'���S � <br /> TENNiT MMI�DONE55 % Cii� 2iP PHONE <br /> iU�it/c <br /> � MCNRECTO�/� M�iL�D09E55 GITY ZiP PNONE <br /> OENER�ICAN �CTOq� M�L�ODRE55 GTY ZIP PMONE LiLENSE� <br /> i��l <br /> ; MECN�HICAL H TOB MAIL�DDRE55 LIIY 21P PHONE LICEHSE• <br /> RUMBIHO T� M�IL�DDRE55 CIIY ZIP PNOHE LtCENSE• <br /> QAS9 F RN <br /> �� ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ PEPAIR DEMOLITION ❑ WOOOSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br /> TEN�NT IM%IWEMENi OH IMEPIOR PEMpDEL OyIY/ fpNUCT PCRSON AND PNONE NQ . <br /> CONiR�CiPRICEOFWpRIt �%/�4\ `/�/�� w� � � , � . <br /> �N/ ` <br /> DEBCRISEWORK�NpSOU�REFO0i�1GEl OLVED -« 'JG � y'��/� <br /> � E �� D�SE' � <br /> PROP09E0 USE OrF BUIlDINO I HEREBY CEfiTirYTHAT I HAVE READ AND EaAMINED THIS APPLICFTION AND <br /> � /{j��� -;�p�;�ucgqMETO�ETRUEANOCARRECT.ALLPROVI510NSOFLAWSAND � <br /> � lEOAL DESCAitt10H PROFERIYISNpWN BEIOW OR�TT�CN FOUR CARES� ORDINANCES GC`JERh'NG THIS TYPE OF WORK WILL BE COMP�ETED WITH <br /> 7 WNETHER SPFGiF1E0 HE�REIN OR NOi.7HE GRANTING OFA PERMIT D(�ES NOT <br /> �p�I�Z IJ gip�K �S aF F����//� PFESUMETOGIVEAUTM�FiITVTOVIOLATEORCANCELTHEPROVISION50F <br /> ANV OTHER STATE OR LOI;AL lAW REGULATING CONSTFiUCTION OR THE PER� <br /> �� .��� FORMANCE OF CONS7Rl,CTION.THAT I AM AUTHORIZED 8Y THE OWNER OF <br /> � /T�Q/r'� T THIS PROPERTV TO PERF�)RM THE WORK FOfl WHICH APPLICATION IS MADE <br /> � AND I COMPLV WITH TkIE STATE CONTRACTORS LAW 1827 RCW AND <br /> ' 286.200 W4C. <br /> ; 5�6N�fUREOFGOHiqAGTOROf1AUl110flRED�GENT D�TE 7/�e� <br /> � <br /> 1 X <br /> �, Pi10JELt�ODRE55 �v USiN[59UG[NSEH E SNAME <br /> ' 37�v COG,B <br /> FLUMBINO . MECHANICAL �� <br /> � NO. 7YPE OF FIIRURE OR ITEM FEE NO. PE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C–A/HNDLO UNITS–H.P. <br /> � BATHTUB FORCED AIR SYSTEMS–B.T.U. M EA <br /> � LAVATORY(WASH BASIN) UNIT HEATERS–B.T.U. M <br /> � gH�WER CLOTHESDRYERS <br /> . KITCHEN 81NK8 DISP. VEN7ILATION FAN <br /> DI6HWASHER RANGE I100D <br /> � LAUNORYTRAY WATER NEATER <br /> � CIOTHESWASHER WOODSTOVE <br /> i <br /> ' URINAL MEiALFIqEPLACEdCHIMNEV <br /> i <br /> ' DRINKINO FOl1NTAIN <br /> � FIREPLACEINSEFiT <br /> � fLOOR DRAIN HE4T PUMP <br /> { BACKFLOW PREVEN7EFS GAS PIPINC, <br /> � ROOFDRAINS–R�INLEADERS E%HAUSTFAN <br /> ; SINK(SERVICE–BAR,ETC.) <br /> I <br /> � <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT E PFRMIT S <br /> TOTAL FEE S TO7AL FEE S <br /> � FHONT6ET&1CN RE�RSEIBACIf SiDE5E1BACN PIANCNECItMUMBER FEE pECEIPTNO. <br /> I <br /> usezoNc iornnee V�GAN751TE FEE: WLUATION FEE <br /> ❑rEs ❑No . _, <br /> TYPEOFCONBT. pp�pPANCYOROUP NO.OF�WElLINOUNli9 BUILDING <br /> •LLOWABLbACiWI - - <br /> PLUMBIN6 <br /> , BREOiBLDO. NOOFBTOHIE9 BSMT. OCC.lORO — <br /> �� MECHANICAL <br /> ❑ N __ <br /> 11[IGNTLIMIi�iION OTIIER <br /> FlRE 9PRINNLERSREOUIREO ❑YE9 O NO STATE BUIL�ING SURCNARGE <br /> STATE ENEfiGY SURCHARGE <br /> �PPLICAi10 �GG PUN9�PPR BY <br /> PUBLIC WORKS <br /> �. TOTAL <br /> I <br />