Laserfiche WebLink
_ . �. :�,____ _ . <br /> APPLICATIC°'� FOR CONSTRUCT'"lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> C EATING SYSTEM: ❑GAS ❑ELECTRIC U � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I I DEMOLITION Ll COMBINATION I i BUILDING L I MEi:HANICAL ❑ PLUMBING �SIGN <br /> OWNER IAAILAODRE55 CITY 21P PHONE <br /> S•9�irF:r fsea�;A�ic-s 9is' /i�t�, .9ac--- se-� acz[cvt��w.9. Ydaas� �S3-/eC00• <br /> T[NANT MAILADORESS CITY ZIP PMONE <br /> !/��Yr�iv .4�rrs�.Pf,c�cFs io�-zi c2r-.Pc�Ff�. wr �=-ycR�rr w�. 9�0�� �i-� -9�i�?• <br /> ARCHITECTORDESIGNER MAILAODRC55 GiV ZIP PHONE , <br /> GENERAL CONTRACTOF MAIL ADOPESS CITV ZIP PHONE STATE LICENSE a <br /> iP�7/ni,�/2 iniLYii:�i(_;f' F'?d S• /ni/JasTRr/1C Gt/% .fi�, ttJd• ,��'�O}� iPAvV/lU,C <br /> �{.1 ECMANICAL CONTR�C70R MAIL�DDRE55 CITY ZIP PHGNE STATE LICENSE n <br /> PLUMBING CONTRACTOF M1IAII�DDRESS CITY ZIP PHONE STATE UCENSE N <br /> CONTRACT PRICE OF WORN d�y . <br /> �_ <br /> OESCFIIBE WORK AND S�UARE FOOTAGE INVOLVED CONTFCT PERSON FND PHONE NO. <br /> - � G _ - - <br /> ��Cc�rro�,-� GoGo- �i- / . /a�P�rrir-' 2' I _ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDECGRIPTIONOFPROPERN�SNOWN6ELOW0 ATTAGHTWOCOPIE ` WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NQT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or 6LOCK cF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHE'1 STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � — 2 � � �, _�,� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX ID.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> 1 <br /> , CONSTRUC110NLOANLEN�ER.NDDRESS.TELEPHONENUMBER /-9 f� <br /> _ �_ � �m��� <br /> � pR0�%TZADDHESS � � n ,a I s�cHnruae o.re ' <br /> /� n*veuswrssuccr+servo <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A�C—AMNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHES DRYEFS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATEH ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOfi DR.41N � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINfi—RAINLEADERS � EXHAUST FAN � <br /> SINK�SERVICE—BAR, ETC.) � — <br /> � ' <br /> � <br /> SUB TOTAL S ' SUB TOTAL $ _ <br /> PERMIT S PERMIT $ � <br /> � TOTAL FEE S ' TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: 7 <br /> FflOYT SETBACK ' iF.AR SET l,G��� SID��TB� J� PL�N GHECX Nt1M8EA FEE . ��� RE'��%0//S � <br /> c.. y/_I // '1 l (� <br /> u�t�'o<n ��, o <br /> USEZONE LOTAREA VFCANTSITE FEES VALUATION FEE <br /> G � ❑ YES '-� N� BUIL�ING � �J(J �j ��� <br /> � <br /> TYPEOFCOI::i. NO.OFSTORIES ocaPa'iw riOofOWFiunGUvrtS i <br /> caouP PLUMBING � <br /> - T <br /> SREOFBLDG. FlRESPRINKLERSREO'D �ASEMENT � <br /> MECHANICAL <br /> �-1 YES ❑ NO <br /> OCWPANCYLOAD FIpE�LAR1dREOT HEIGHiLIMITATION <br /> ADDIT:ONAL PLAN CHECK ; <br /> _ OTIiER <br /> REASON <br /> STATE BUILDING SURCHANGE i �,j� <br /> � INTAHEBV PL�115APPROVEOBY CITYOFEVERETT PUBLICWOFKS � <br /> �M LOCALSALES � <br /> oATE � �3 !�� TAX CODE IS 3105 TOTAL �� ; �� <br />