Laserfiche WebLink
APPI.ICAT10� FOR CONSTRIJ�T�N PERMIT everett <br /> IheEvargreen TO BE COMPLE"fED IN INK—PLEA.SE PRINT � i. � <br /> CITY OF <br /> �verett HEATING SYSTEM: ❑GAS ❑FLFCTRIC ❑ <br /> BUILDING DEPAR'iMENT � <br /> 259-8810 <br /> ❑ DEMULITION ❑ COMAINATION C: BUILDING '/_i 'eCHANICAL ❑ PLUMBING '�� SIGN � <br /> OWNER AIAIIRDDRE55 CITV 7.IP PHONE '� <br /> C V Q� I�4y� �l i <br /> I� O � TEN0.NT lARILADORESS CITY ZIP PNJNE <br /> f� � � /G��jirroi Ol�ll��1���fi���S3n3- os' �i/er��cr.��J�u Fi�i�'F ���<J3 <br /> p ARCHIiECTONDE51f•NER AILAD�M11 ORE55 J �;Ty � ZIP PHONE <br /> Q <br /> � GENERpLGONTflRCTOP. MNLA��f1E55 CITV ZiP PHOIIG LICENS[e <br /> N H <br /> 1! O MECHANICe�f.ONiRPCTOR MRILAOD8E55 CITY ZIP PHCNE LICENSEY <br /> ���a e, . ,.�f(���. 7eF� 5�.r�'o � 5t' _.6'� �Ba3 Z- <ri ?�rh ���liT_z �r.�a�T <br /> � VLU ING CONTiACTOR C' MAIL AOORESS CITY ZIP PNONE LICENSE t <br /> W�Q ' <br /> .LASS OF WORK <br /> ^� d C' NEW ❑ ADUITION �ALTERATION ❑ REFAIR ❑ DEMOLITIOtJ Li WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> ON <br /> O�J-(y �o� W NTAGT PERSON PND PHONE NO. <br /> S]�(7 CONTRPLT PRICE OF WORH 7� Y.'�. � � <br /> OESCRIOEWORNAN�SOUAREFOOTAGE�NVO�YED �/ Q-�p� SFs-/ <br /> �y� PROPOSEO � OFpl11L01N /�J S y ��� Z L'c(.tLY.� <br /> p.�- I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �W H _ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> �[A LEGRL�ESCFIIPTI OPPROPERNISHOWNBELOWORATfACHPOIINCOPIES� PROVISIONSOFLAWSA�i10RDINANCESGOVERNINGTHISTYPEOF <br /> � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OF A PEFMIT �OES NOT PRESUME Tf}GIVE <br /> AUTHORITY TO VIOLATE OR C.4NCEL THE PROVISIONS OF ANY <br /> p(�p OTHFR STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 7HE <br /> �- - PERFORMANCE OF CONSTRUCTION.THAT I Ald AUTHORROD BY THE � <br /> OWNER OF THIS PROPERN TO PERFORM T`1E W07K FOR WHICH <br /> APPLICATION IS MADE AND I COMNLV WIT4 THE STATc <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 W/,C. <br /> SIGNFTUREOFCONTRqCTORORAUTHOFIZEDAGENT OfdE <br /> PRQIECT�PRRE�� � -n�/ �—y�� <br /> , � 5 �'�('�f �`PP{'� APPLICANTSCITYBUSINESSLICENSENO.MlDBUSIhE55NnME <br /> i�-' -'-�;\r PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEG <br /> , ��' WATER CLOSET(TOILETj � NC—NHNDLG UNITS—H.P. i <br /> � BATHTUB ' FORCED AIR SYSTEM1IS—B.T.U. M E.A. ' <br /> + LAVATORY(WASH BASINI� i UNIT HEATER.C—B.T.U. M i <br /> '�e ' SHOWER i CLOTHES DRYERS � <br /> - vi KITCHEN SINK B DISP i VENTILATION FAN ; <br /> � DISHWASHER � RANGEHOOD � <br /> i LAUNORYTRAY ' WATERHEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> I pw URINAL � METAL FIREPLACE 8 CHIMNEY i <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> '� FLOOR DRAIN HEAT PUMP � <br /> d ' BACKFLOW PREVENTERS GAS PIPING ; <br /> i ��� flOOF DRAINS—RAMIEADERS EXHAUST FAN � I <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> I <br /> i <br /> � !1`I ' I'� <br /> � <br /> , ; <br /> ��, SUBTOTAL $ SUBTOTAL $ `— . <br /> � PEFiMIT $ PERMIT $ /.5 ; — � <br /> =� � TOTAL FEE $ TOTAL FEE $ ,�j ' �I <br /> � , FOR OFFICE USE ONLY: ! <br /> FRONiSEfBACY. REARSETBACN SIOESET�RCK PIANCHEGKNUM�Efl F[E RECEIPiNO. ' <br /> USEZONE LOTPREF �ACPNTSITE FEES VALUATION FEE � <br /> BUILDING � <br /> iVPEOFCONiS.AIIOWPBLE iYPEOiWNSTACipAI aC[uGnrvtv xo.o��wttw�Guni�S <br /> GP0°P pLUMBINf. i <br /> . SIZEOFBI.DG. NO.GFSTOPIES BASEIAENT MECHANICAL ��j' <br /> i <br /> UCGUPANCYLORD FIRESPRNKLERSflEO'D HEIGHTL�lAITATION ADD�TIONALPLANCHECK i <br /> I OTHER � I <br /> flEA50NFOR5PRINKLERS � --� <br /> � STATE 6UILOING SURCHARGE i <br /> INTANEBY PLANSAPPROVEDOY CITYOFEVEHETT PUBLICWORKS i <br /> LOCALSALES , <br /> TAX CODE IS 3105 70TAL ����;�'; , • <br />