Laserfiche WebLink
' ' ' APPLI��►f10N FOR CONSTRI..:�'ION <br /> , , <br /> � � PERMIT <br /> Iho Evergreen cvt•trll <br /> CIT1'OF <br /> everett � � <br /> �UILDING DE^.�RTMENT � <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> OWN[R AIAILPpoR[55 CIIY ZIP PIION`. <br /> $ ieKrr lnat��.pr y,'a-/Gm <br /> ��� �IENA t'---���i MAILAOORESS OIY ZIP PNONE <br /> Yv,� }� (/�kj�P,��,<�i9 Ti,� . l�'o, �:�c y�`l G;�i��b:.� i3'33; __ <br /> � � a�'HILEGi0fi0E5�GNER MAILADDRE55 � ZIP �NONE <br /> � �� L� f�J S Sc•�<fi�l 93'i6S `J33 -�Fi7 I <br /> � �+ �a,,,�Q �el��e f�rl�ilech /�57ry ��fi¢-v- � � <br /> H GENEPALGONiRPGTOfl MNIIADDRE55 CILY ZIP PMONE IICENSE• <br /> �-'�� �s . y �r / o 'c'�» 339��--S� ,aie �a'1'3:3 _ �b'�33 <br /> '� cnv zia r�ioHE yF��s <br /> MECHANiCALCONiRACTO MAtLA00RLS5 N o Eqr <br /> ��Pv � ; P.:-I�.,� o i�-�'- /1� YcYoJ' /P��:ccr�r �iok�t�P i9��o7 �9'�9� `�d'3 130�;� i��o�3_ � <br /> ((1 � PL11M1101NGCONTRAC' MAILPDDRE55 � GITY 21P PMON[ LIGGNSE• <br /> r � <br /> O�f� 0.n35 oF woen <br /> � � NEW ❑ AD�ITION ❑ ALTERATION ❑ REPAIfI ❑ �EMOLITION ❑ \400DSTOVE/FRPL INSEflT ❑ BUILDING REIOCATION <br /> ��g T[NANiIMGFOV[MENTORINiERIORPEAIC�ELONLV CONiAGTPLFSONANDFMUN/E�NO <br /> He � CONTPACTPRIGEOFWORK _ �Il� ,J[_V1f4cVr: Ch2`4 ��.'; '���44 <br /> �H UESCRI�EN'ORNAN�SOOAREFOOTAGEINVOIVEp I� C I <br /> �y� � /� C o �- ct� J���-�ll�L� — I <br /> HH PROPOSEDVF`^ro'J�LDING IHEFEBYCEHTIFYTHATIHAVEREADANDE%AMINEDTHISAPPLICATIONAND � <br /> �� KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND I <br /> �y H p� S'I'o� Q ORDINANCES GOVEFNING THI5IYPE OF WORK WILL BE COMPLETED WITH <br /> �� LCGALOES:RIP ONOIPRDPEFLYISM05YNBELOWOPATTAGHfOURWPIES) <br /> � WHETHERSPECIFIEDHERE!NOaNOT.THEGRANTIt1GOFAPERMITDOESNOT <br /> � PRESU ME TO GIVE AUTHORITV TO���OLATE Ori CANCEL THE PROVISIONS OF <br /> � LOi OtoCrc ov ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHCPER� <br /> FOR^AANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BYTHE OWNER OF I <br /> (q THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS M.1DE <br /> � � -�� � AND I COMPLV WITH THE STATE CONTRACTORS LA1V 7827 RCW RND <br /> 296200 WAC. ' <br /> SIGNATUREOFCONTRACTOROnAUTMOHREDPGENi DATE ' <br /> E�cr reP � �6,/ �, /d� st S U.� ��rc3� <br /> X .��� -�r�-<-f� 6���i`�' � <br /> PROJELiAOO 55 qPp�IGPNiSCIiYBOSINESSLIC[NSENO.ANDBUSINESSNAME <br /> PLUMBING MECHANICAL I <br /> �� NO. TYPEOFFIXTUHEORITEM FEE NO. TVPEOPE�UIPMENT FEE �,I <br /> � <br /> A/C-A/HNOLGUNITS-Hfl ,7 i S X' <br /> I '`�'� WATERCLOSETITOILEp — � <br /> L�� BATHTUB FORCED AIR SYSTEMS-&T.U. M EA <br /> � � LAVATORY(WASHBASIN) � UNITHEATERS-BT.U. �.1 f9po�» 1 � <br /> I � CLOTHES ORYERS _ '. <br /> SHOWER <br /> �� KITCHEN SINKB DISP. VENTILATION FAN <br /> !�I DISHWASHER RANGE HOOD '� <br /> � LAUNORYTRAY WATER HEATER � <br /> CLOTHES WFSHER �M1'OOD STOVE <br /> ' URINAL METAL fIREPLACEB CHIMhEY _ I <br /> I ' '� GRINKI'!G FOUNTAIN FIREPLACE INSERI i <br /> � HEAT PUMP <br /> � FLOOR DRAIN � <br /> BACKFLOWPREVENTERS GASPIPING _ _ . <br /> � ROOF DRAINS-RAINLEADERS E%HAUST FAN <br /> I 1 SINKISERVICE-BAR,E7Q1 — � <br /> i �� <br /> i , <br /> �� _ <br /> SUBTOIAL 5 SUBTOTAL S S � <br /> PEFMIT 5 PEFMIT 5 � , <br /> '�� TOTAL FEE 5 TOTAL FEE 5 , <br /> I ��� FRONTSETpACK RERRSETBAGK SIOESETOAGN PLANCNECNNUMBEH FEE flELEIPTNO. (O! . G <br /> � ` <br /> �. <br /> usEzoN[ LOTPREA VACRNTSIiE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> BUILDING <br /> iVPEOFCONST. OGCUPnNGYGROUP NO.OFOWELLINGUNIiS <br /> pLLOWABLE/ACTUAL PLUMBING , <br /> SREOF9LOG. NO.OFSTOPIES BSMi. OCC.�ONO MECHANICAL Iv � � I <br /> ❑Y <br /> ❑ N <br /> MEIGMTLIMITATION OTHER � <br /> FIRESPPiNKLEBSREGUIa�o ❑ves ❑No S7ATE BUILDING SURCHNFGE �i <br /> STATEENERGYSURCHARGE <br /> APP�IGATIONACG.BY PLhNSFVPRBY PUBLICWORKS <br /> �� � TOTAL � <br /> t ` <br />