Laserfiche WebLink
AiPPLICATiG.�I FOLR COPISTFiIiCT.,JN l�ER�iIIT <br />x�,� e,-��,,,,,r„ TO 8E COh1PLFTED IN INK—PLEASE PRINT <br />cirv or <br />everett <br />�UILDING DEPARTMENT � <br />259•8610 <br />DEMOLITION COMBINATION <br />�'���+�� rdnl.nCon[SS <br />-AsGnDEO�V� Lru�ur �, �Ne <br />�r_a.��rtnvrY:��:�� - � �_ <br />�E:unrir rani,.no�ness <br />HCATING SYST6Ae J GAS �� [LEC7RIC 'J ___ <br />1C BUILDING <br />urr <br />MECHANICAL PLUMBING <br />l�� PNONE <br />n <br />SIGN <br />_it rc. -aTResW�T `1 31 (:ORPOKAtr CtIe.DR. PoM���A `I 1 I!o`� �114)3`l�-3joS <br />nNC1UTELTOR�[S�GN[R I.UILAO�RESS GTY 'iP PHONE <br />1?`LE;��fd�LA�4f1.�Ao�-ILoz�}�i��-rrA�l� FVi:IL<�f(�.9_98Lo1 Z�`�-31�1 <br />��fINL7ALGONif7ACTOR MAILIDCRE55 CRv ZIP PHONE LICENSE� <br />_�k�U Ce�rC�✓�up l�+�i4"1 1�E LR�r �E�-19o� r�,z,i�enr2,}Q(�R�Q,y2�) g�,l -14G�G SJ'0 �I <br />.:FCHAILCALLONTB�GiOfl MAILADDdESS FHONE �.�L�y� <br />IICENS[ � <br />P:UMD�YGCONTRACTOH I.IAI�A�iDHE55 CITV ZIP PHONE LIC[NSE• <br />c�nssoFwoi'K F.f.l� hly-(- �p�''�� 1'1 {,� S N � F <br />�X NEW . ADDITION �. AiTERATION . fiEPAIR DEMOLITION � WOODSTOVE/FRPL INSERT � BUILDING FiELOCAT10N <br />�p o I CONTRCT PLG V1u nul� nunue ur� <br />CONiqACTPRICECFWpRK K ZUrOD <br />Uf SCR�PE V/ORK RN:150UARE FOOiAGE INVCLVGI <br />f• �.___ SNevf���r�. — . <br />rr�orosco use o= om. oiHc <br />_����itt,� � I a �y.^�� <br />LF.Gnl0E5CBiPTiOH OF PPO'eRtt �SMOLNI BELOi <br />l0f _ {3�p�N OF <br />FOUR COPIES) <br />PHQI'_'CT ADDFE55 <br />��loh� irV�Y�L�1��1` �+��A-U ��'7i <br />PLUMBING � <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB -- <br />LAVATORY (WASH BAS�N) <br />SHOWER — <br />KITCHEN SINK E DISP <br />DISHWASHER <br />LAUNDRY THAY <br />CLOTHES WASHER ' <br />URINAL <br />DRINKING FOUNTAIN � <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS � <br />ROOF DRAINS—RAINLEADERS <br />_ SINK �SERVICE—BAR. ETC.) <br />FOR OFFICE USE ONLY: <br />c.-;�tSH�nCN REARSEI <br />_ _�i S <br />..`.CZCI�F IOTAREF <br />.n5`C��' C`C415:!iGl'rn! <br />-4�V <br />G�OLDG <br />�%� ��.�. <br />'iCCi �P4NCY IOAD <br />a <br />� <br />NfU�50!! FOR SPqINNL <br />�Z. � <br />lillAH[ �]'/ <br />SUB TOTAL <br />PERMIT <br />TOTA� FEE <br />iYPE OF COIiSi A�TUAL <br />� <br />NOAF STORIES <br />� <br />FIqE SPyi�iNNLERS FEO � <br />YL'i7 <br />��� <br />v� v�s nNanoveo � r <br />1 �21��93 � <br />� <br />� <br />VACANT SITE <br />�O <br />IXN�:4uY 1.00%6M1IlO'KL'L'S <br />Mp��P � <br />NO <br />�C UMITAiION <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />/Q'K _�aD <br />I HEREBY CERTIFY THAT I HA�/E READ ANC EXAMINED THIS <br />F.PPLICATION AND KNOW THE SAME TO OE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINl�NCES GOVERNING THIS TYPF OF <br />WORK WILI BE COMPLETED VJITH WHETHER SPECIFIED HEREW OR <br />NOT. THE GRANTING OF A PERMII DOES NO�� PRESUME TO GI'/E <br />AUTHORITY TO VIOLATE OF7 CANCEL THE PROVISIONS Of ANY <br />OTHER STATE OF LOl;AL LAW REGULATING COIJSTRUCTION OR i H[ <br />PERFORMANCE UF CONSTRUCTION. THAT I AM 4UTHOR12ED BY THE <br />OWNER OF THIS f'ROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AMD I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7827 qCW AND 296200 WAC. <br />9GunTUREOFCONTqACiOROFAUiHOR1ZEDRGENT D�-E <br />� <br />/ <br />",1� ����'� '/; �j �� <br />APPUCANR GiV OUER'[SS UGEI�SE NO .VID OJ51!1E55 NPME <br />NO. TYPE OF EOUIPMENT <br />AiC—A�NNDLG UNI iS--H.P <br />FORCED AIR SYSTEPd:i—B.LU. M E <br />UNIT HEATERS—B.T.U, Id <br />CLOTHES DRYERS <br />VENTILATION FAN � <br />RANGEHOOD <br />WATER HEATER <br />METAL FIflEPLACE G <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILDIt.G <br />PLUN�ING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />O7HER <br />STATE BUILDING SURCHARGS <br />PUBLIC WORKS <br />TOTAL <br />0 <br />SUB iCTAL y' <br />--PERM111- 5 <br />TOTAL FEE 5 <br />� �� � � ��� / �G�J <br />VALUATION FEE <br />�QQ� .� %� <br />_— '/ ..`) /. <br />� ---�— <br />7� /_ � .1?' <br />