Laserfiche WebLink
APPLIC.�TION FOR CONSTR�CTION <br /> Ihe Evergieen PER M IT <br /> CITY OF <br /> everett �°efP« <br /> BUILDING DEPARTMEN"i � <br /> 259•8810 TO BE COMPLETED IN INK— pLEASE PRINT <br /> OWNER <br /> � MAIL ADOqESo '., / CITY <br /> TE��A/U-5�(I Ok�� �D�� ��✓� cl� �-1/f�t,�G(�j4 q�'� P�(,/S ��I� <br /> �. �141L ADJRE55 CITY <br /> Z�P PHONE <br /> ARGHIT SIG - <br /> ��(�.Q� / � ///J �. rRti — Z <br /> MRIL ADDqESS <br /> �"_ ,/�-��C �� L:Ei�� "1/�� � �ryP�HONE �"'7// <br /> GE �CONTRACTOR MAiL4pDRE55 —�` /����� �t/'��� /TJ�JJ S <br /> ��Y PNONE <br /> G'L'I L r' l( /! ' // / / IP IICENSE x <br /> ECNANICALCONTRACTOP l� <br /> �, MAIL ADDRE55 ��TY <br /> Z�P PHONE <br /> LICENSE e <br /> PWMBINCCONTqRpTOR MAILADCRE55 -- � <br /> r GITY 21P PHONE <br /> LICENSE� <br /> C�L,A/SS OF WOpK - <br /> YJ NEW ❑ A��ITION ❑ A�TERATIUN ❑ RE IR DEMOLITWN [� WpODSTOVE/FRPL INS[RT ❑ BUIL�ING RELOCATION <br /> TENRNTiMPPOVEMENTORINI' qNEM00ELONLV �l <br /> ^.n� CONTACT SONANOPHONENO <br /> GONiRACTPRICEOFWOPIE O I✓ L� �S�J�S ��q.i,�,(Gn- �_ -� <br /> DESCRIBEWORKRNOSOUAR FOOTRGEI VOWED �_7L�J ��� <br /> t�rZ"%�c��_j��,���� <br /> PROPO$EpUS OFBUILDING/ <br /> (�����c�.,, IHEREBYCERTIFYTHATIHAVEREADANDEXAMIKEDTHISAPPLICATIONAND <br /> L� KNOW THE SAME TO BE TRUE AfJD CORRECT.ALL ppOVI510NS OF LAWS AND <br /> iecn�oescairnoNOFPaoaeanisHowrueeiowoqniracr+Fouacoaies� --- OfiDINANCESGOVERNINGTHISTYPEOFWORKWILLBECOMPLETEDWI7H <br /> WHETHER uPECIFIED HEREIN OR NOT.THEGFANTING GFAf'ERMIT DOES NOT <br /> �Or e�ocK oF _ PRESUME TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br /> � FORMANCE OF CONSfRUCTION.THAT I AM AUTHORI2ED BY THE OWNER OF <br /> THIS PROPERNTO PERFORM THE WORK FOR WHICH APpLICATION IS MADE <br /> [�� / AND I COMPLY WITH THE STATE CONTqACTORS LAW 1827 pCW qND <br /> T!� ..�� 7'-f�c/'�G��G��"�� 286.200 WA <br /> / ATURE OF ONiP:G�n; ,�AUTNORI pGENT DRTF IG����� <br /> ic��ZS G �'c� , <br /> PPOJECTr�00RE55 �, — /��(I,�}j"�u,V�y �IJ . UF ��wj/j-B/� '� <br /> C�J�� ��/� � PPLICAN SCITYBtISINE55 I„EN ENO.ANOBUSWESSNAME � <br /> PLUMBING <br /> MECHANICAL <br /> N�• TYPE OF FI%TUpE OR ITEM FEE N0. — <br /> WATER CLOSET(TOILEn n'�E OF EOUIPMENT FEE � <br /> BATHTUB NC-lVHNDLG UNITS-H.P. <br /> FORCED AIR SVSTEMS-BT.U. M E0. <br /> LAV4TORY�WASHBASIN) �NITHEATERS-B.T.U. M <br /> SHOWER <br /> CLOTHESDRYERS <br /> KITCh:EN SINKB DISP. VENTILATION FHN <br /> DISHWASHER <br /> LAUNDRYTRAY � RANGEHOOD — <br /> WATER HEATER — <br /> CLOTHES WASHER <br /> URINAL <br /> WOOD STOVE <br /> - METAL FIREPLACE 8 CHIMA'EV <br /> _ DRINKING FOUNTAIN _ FIREPLACEINSERT <br /> FLOOR DRAIN <br /> HEAT PUMP —� <br /> BACKFLO'�N PREVENTERS GAS'IPING -- <br /> ROOF DpAINS-RqINLEADERS EXHAUST FAN <br /> SINK�SERVICE-BAR,ETC.) — _ <br /> SUBTOTAL 5 SUBTOTAL g <br /> PERMIT $ PERMIT <br /> TOTAI FEE '� <br /> FRONTSEfBRCK $ TOTALFEE $ <br /> REAR SETBRp( SIDE SEIBPGK FLpN CMECK NIIMBER <br /> � � tO I � FEE pECEIPfNO. <br /> WEZONE LOTRREA WCANTSITE / ,`� ��� <br /> C— / OOO � ❑ ves �(o FEES VALUATION FEE <br /> TYPEOFCqNST. OCCUPAN YGROUP NOOFOWELUNGU01T5 BUILDING � <br /> RL�OWA E/pQUAL IS �I� �� <br /> �/✓ / PLUMBING <br /> SIZE BLDG. NO.O TOHIES BSMi. p�q�OAD — <br /> ( �N MECHANICAL <br /> � <br /> HEIGNT�LM}�IT9TION OTHER <br /> FIRESPqINKLER5RE0lIIqEO �VES �NO J V — <br /> STATEBUILDINGSURCHARGE — 50 <br /> STATEENERGYSURCHARGE <br /> APPUCATIONRGC.BY P�pNSRPPR.BY <br /> PUBLIC WORKS <br /> -- � �� � 71 TOTAL /�� �n <br />