Laserfiche WebLink
ir,, i,�-���. , <br /> i A�PLI�TION FOR CONSTF�CTlON <br /> PERMIT <br /> � fhe Everpreen everett � <br /> , CITYOF � '. <br /> �� everett ; <br /> BUILDINPDEPARTMENT <br /> ' 259•8810 TO BE COMPLETED IN INK— PL[ASE PRINT ' <br /> � <br /> � OWNE (� MAILr1D/O,PyE�55 �./ GIV �jZIP� p� PNONE �Q� ��,. 1 <br /> TENANT ������—^"71 �II� �h � SL � IIO 1v'C(ICYGC �V� �5��IILZ/ �i <br /> MRILAODR 5�S CITY 21P PHONE %A1 7Af �({6/ i <br /> CA✓I FD�NIA OEG-� �vz-P�t/ 'ld ^c� 19_,_.II� EVF�CG�q�PP,✓�t.�9Y �4g�o¢ j <br /> , �RLMITECT'JROESIONER MRIIR�ONLSS ���Y Z�P ^��tACN.§rg I <br /> )'YrfL .(# <br /> ��� <br /> GENERALCONTR�CTOR MAILAODHE55 CRY EIP /P/HOpNE LICENSE• <br /> 5�1�� �c/ �n/�c C� �an/ in/f_ /-7P7�.Q �r/P-O.�A /1/. 5�.4T/�GE. I.✓Q, �/6��3 S:NORESilloJ <br /> � MELH�NIC�IGONTRACTON M�II�D�NE55 GITV i� PMONE UCENSE <br /> � PLUMBINOGONTH�CTOR MRILADDRESS CITY ZIP PIIONE LIGENSE• <br /> CLA59 OF WORH <br /> , FSW�_AQPITION ❑ ALTEAATION ❑ REPAIR ❑ OEMOUTION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> ENANTUAPflOVEMENTON�NtER10 REMODELO7N�Y LONI�CTPENSONANDPHONENO <br /> � GONTR�CTPRICEOFVIORIQ 3��(�[/ <br /> ' OESCRIBE WOflKANC SOU�RE FOOT�GE INVOLVEO <br /> � INS �ou�o eu�/oi�0����� �/�a`�, IHEREBYCERTIFVTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> /'7 ., ,p/ KNOWTHESAMETOBETRUEANDCORFiECT.ALLPROVISIONSOFLAWSAND <br /> ��'�� ��� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br /> LE(3ALOEBCNIPTIOYOFPROPEHTYI9HOWN6ELOWORATTACHFOURCOPIES� WHETHERSPECIFIEDHEREINORNOT.THEGRANTINOOFAPERMIiDOESNOT <br /> PRESUM�TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> � �ot BLOCK_ OF ANYOTHERSTATCORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> FORMANCE OF CONSTRUCTION. �HA71 AM AUiHORIZED BYTHE OWNER OF <br /> THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 78.�7 RC AND <br /> 296200 WAC. �/�� � <br /> � SIGNR7UQEOPCONip�GlOfi AUfN 12 OR ORiF <br /> � � � . <br /> �O'��� �G �1�� _1 .C,Ld '�l/�� <br /> � FiOJECTAD�RE35 �PpLICRN15CItYBU51NE551.IG NSENO. NDBUSINESSNRME • <br /> /� ; N � ` c'e � 3¢ ! SNo�L�,+/� �'/ <br /> P!.UMBINO MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF f:OUIPMENT FEE <br /> 1NATER CLOSET(TOILE� A/C—A/HNDLG UNITS—H.P. <br /> � BATHTUB PORCED AIR SYSTEMS—B.LU. Ki EA <br /> IAVATORY(WASH BASIN) UNIT HEATERS—flT.U. M <br /> ;�HOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 OISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TPAY WATEFi HEATER i <br /> CLOTHES WASHER WO00 STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEY i <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> HEATPUMP � <br /> FLOOR DRAW � <br /> BACKFLOW PREVENTERS GAS?IPING � �I <br /> � ROOFDRAINS—FAINLEADERS EXFIAUSTFAN i <br /> I <br /> SINK�SEFVICE—BAR,ETC.) -- � <br /> I <br /> SUBTOTAL S SUBTOTAL $ _ <br /> ' PERMIT 5 PE7MIT $ <br /> TOTAL FEE 3 TOTAL FEE S <br /> FPONTSETB�CK REARSET6nCK SI�ESETfl4CN PLANGHECI(NUMBEP T�iE flECEIPfNO. . <br /> U9EZONE LOiAPEA WCANTSITE FEES I VALUATION FEE � �I <br /> G ,' ❑YES ❑ NO � <br /> BUILDING � . <br /> TYPEOFCONST. OGLUPRNCYOROUP NO.OFDWELLIN�IINITS <br /> AL�OWAB�E/AGTUAL PLUMBIIJG ` <br /> 61ZEOFBLDO. NO.UFSTONiES B9MT. OGGLOFD MECHANIC�IL <br /> ❑Y <br /> O N <br /> HEIGNTLIMITFTION OTHER <br /> FIRESPRINNLEflSPEOUIPED ❑YES ❑ NO STATE BU!L�ING SURCHARGf. ' � <br /> STATE ENERCaY SURCHARGE � <br /> APPLICFTIONACG6Y PLANSAPP r pUBLICWORKS � <br /> ✓ ^r <br /> TOTAL __ <br /> ...... , _. ._ . . .. . <br /> _. . . . . . �.. .:, � . . . . f� <br /> -. ... . ._....... .,.._ . . -� <br /> �*---•:.. .. ... . . .. . . . , .. . . , . <br />