Laserfiche WebLink
1 <br /> +r, r++ <br /> APPLICATION FOR CONSTRUCTION <br /> PERMIT <br /> me Everpreen �•��'�P�� <br /> � �„� CITVOF q <br /> "° everett � %�� e <br /> �`„�� . " BUILDING DEPARTMENT <br /> y 259-88i0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> ��N OWNER MAILA�OFE55 CITY �ZIP VHONE <br /> f <br /> �� � i�au� E� tiiti �G3� FiPioav���� /L_ 9Y.2oi _75 -/Z6� <br /> ��(1 IENANT MAILF�DflESS CItY ZIP PHONE --- - - <br /> ���v'''III K �jl F sI SHNnDu �LinM1 ✓�63/ F /OFI �NF. �(/ErY�7/� �_�0/ o25�'y26G <br /> f]�[� qqCNITECTOF StGNEN MAILPDORE55 QTV ZIP PHONE <br /> "' �' � ` G 3 <br /> � � L� N C.- v CJ ` 2 Co Y v. `f a� I <br /> d GENEMLC �tAGtT�OA MAILn�OPE55 /� I Grv ZIP PHONE /LiCENSE <br /> pC�g �e t EX-Hl�,E �us—T�n.l �l73S�aJar'c��,�u/ �(a.U� �=�/- /n(+'�a3 �4.,7-�`7c' 6�E�/S//.e�c ��vfrKo <br /> N MAILA�OFE55 C ONE LICENSEa <br /> � C MECMNn�CALLONTPACTOP <br /> X!-�� GV &c ' ' . � ;Ct.-Tiu > P.- /'�.� /su b 3 // �s sr k'" �u G -'L'��- ' / i=/-E�ro s. <br /> sy' GWM&NGL TflACTOP MAILPDDflE55 CRY ZIP PMONE LICENSE%��KT <br /> " n � / � J g - �s S�ou.��,� �9a�L iss- �5s� <br /> t t-�H d. ir +✓ t��-nz �ti • I l ic r� 8� o Su <br /> ��M C1P550FNVPK � <br /> ('� GO �NEW ❑ ADDITION ❑ A�TERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BOILDINGRELOCATION <br /> �� TENANIIMPBOVEMENTOPINTERI FELOD�LON�Y � CONTAQ/P�EFSONNN�PXONENO. <br /> s-. ./�,r✓ o: 'L+EQ4L0 � �RK��� Cc�7C� <br /> CONTRNCiPFIGEOFWORK � 3 7 <br /> y' Q� OES(:FIBEWOFNANDSOUAREFWiAGEINVOLVED <br /> .�, a �s. �� ys� <br /> �1= — <br /> vaovaiEo usE or BuaoiNG I HEREBV CERTIFY THAT I HkJE READ AND EXAMINED THIS APPLICATION AND <br /> ' SF� KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF l R'vVS AND <br /> ORDINANCES GOVERNWG THIS TVPE OF WORK WILL BE COMPLETED WITH <br /> �Ecn�oesCaivnOHovvPoveAtt�SNowrve��owoan**nwroUacOPie51 WHETHERSPECIFlEDHEREINORNOT.TriEGRANTINGOFAPFRMITDOESNOT <br /> PRESUME TO GNE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> I� �OT � e�ocK or ANYOTHERST4TEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> � q _ THISPROPERTYTOPERFORMTHEWORKPGFWHICMAPPLIGATIONISMADE <br /> �,/ AG ��[�j_ AND I COMPLV WITN TNE STATE CONTRACTORS LAW 1827 RCW AND <br /> —� � 296200 WAC. <br /> SIGNAiUPEOFCONTFPQJPOcAU1N 12E�AGENT DATE <br /> x 1i-�✓=r—✓r�t�as;�'�a�iT- �(X � �-� �(� <br /> PflWECTADOPE55 A LICANTSQTVBUSWESSLIGENSENO.PNDBUSMESSNAME <br /> � <br /> PLUMBING MECHANICAL <br /> I� NO. n'PE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIVMENT FEE <br /> WATERCLOSEf�iOILEi) A/C_NHNCLGUNITS—HP�. <br /> '�' BATHTUB FORCED AIR SYSTEMS—B.T.U. F_A <br /> '�' LAVATORV(WASH BASIN) UNIT HEATERS—6T.U. M — <br /> SHOWER CLOTHES DRVERS <br /> KITCHEN SINKB DISP. (�j VENTI�ATION FAN <br /> ' ' OISHWASHER RANGEHOO� <br /> '�1 _ LAUNDRYTRAV WATER HEATEfi <br /> CLOTHES WASHER WOOD STOVE <br /> ' ' URINAL METAL FIpEPLACE 8 CHIMNEV <br /> � FIREPLACEINSERT <br /> DRINKING�OUNTAIN <br /> '�1 FLOOP DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTFRS � GAS PIPING <br /> 1 ' ROOFDRAWS—RAINLEADEfiS � EXHAUSTFAN <br /> � <br /> SINK�SEPVICE—BAR,ETC) <br /> ' <br /> ' ' � �l w �T <br /> '�j � SUBTOTAL $ _ SUBTOTAL _ $ . <br /> � PERMIT S PERMIT $ <br /> TOTAL FEE $ __ TOTAL FEE $ <br /> � SIOESETBPGK FIANCHEGNNUMBEF FEE FfCEIPTNO. <br /> FRONiSEf&1CK FEPRSEfBACK <br /> 2G 2U �' � 9/ �6 7 vG S. n o y°I S"9 <br /> u5ezor�e �o*AaEt. vnGnrvrsire FEES VALUATION FEE �I <br /> R—� Z$0� t,{'. ,•es =�o Bui�oiNc #132 192. _15 _ i <br /> iVPEOFCONffi OGGUPANGVGPOOP NOAFOWEL�NGUNITS — — i <br /> auown0� � crUn� R � PLUMBING _._ _ __ � . <br /> s2eorelo�`� rvoorstoaies esa+�. occ�ono MECHANICAL <br /> Lb88 ^` -- <br /> �a 5r 4ox 2 5r� N A � - Qti�•vv ZZ 7 <br /> HEIGXTLI`MITATION OTH .p <br /> vwESvewrc�EnSaEnweED ��vEs D(r+o y� l STATEBUILDINGSIIRCHARGE <br /> STATE ENERGV SU FCHARGE __ <br /> nacucanoNnuev v�auSnPva.ev PUBIICWORKS Z <br /> //^' <br /> '� N S/� 'rOTAL L ZS I <br /> � y <br />