Laserfiche WebLink
T-6zyZ5 �/�l�ary <br /> APPLIC TION FOR CONSTRVCTION <br /> �he E,�,�.ee� PE R M IT <br /> CITY OF <br /> everett everett <br /> BUILDING DEPARTMENT e <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MRILAODRE55 CI1V ZIP PHONE <br /> � it7 �2f� 2dt1 � <br /> °�.` • S ' 3 � ' 7z�.s`a <br /> NANT MAILAODRE55 CITY 21P PHONE <br /> ' C%� • (0�.. .�>� l�, 9� <br /> A�RC7HITECTORDE NEP p MRLAODFE55 CItY ZIP PHONE <br /> (.�s.nt-.tia�([�ia,� /JU ��Or,ni ��f'21( 61 �� /!� /.t� .�p�m�.✓Q 9�OZ 7�3 L/ <br /> GENEPAICONTf1ACfOR MRILqODRE55 �'J�� <br /> CITV 21P PHONE LICENSEs <br /> �-�".�e �'� ���„��,�,. /u� v� ,�nx z7z7 /4p„�„A „� 9�0 73 ��� 3�..5-a <br /> ME HANIC LGONTR�GTOR M�IL�DDRE55 CITY � ZIP PHONE <br /> LICENSE s <br /> �r�.��," „M /< r 7z7 S ��m. c9� �'e.� ��io� _ 7�3—i?�� LVI��=�N N/I.L-.� <br /> � � � MFILADDPE55 CITY 21P PMONE ` L10ErygET�t�� <br /> C1A530FVqpK <br /> �Y NEW ❑ ADDITION ❑ ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSER7 ❑ BUILOING RELOCATION <br /> IENANTIMPFOVEMENTORINTEFIORFE ODELONLY CONiACTPEREONANDPHONENO. I � <br /> � CONTMCTPRICEOFWORk J �I Cr lA�/ `�.'� /j)_�7(� <br /> OESCRIBE WORK FND SOU�PE FOpTAQE INVOWED o <br /> �Hsf,clp ✓Ac � � < p <br /> PROPOSEU U9E OF BUILDINO <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> �ea�li.o���o�FPROPERIV�SMOWNBELpWOPATTACHFOOFCOPIES) KNOWTHESAMETOBETRUEANDCORRECLALLPROVISIONSOFLAWSAND <br /> OFDINANCES GOVERNING THIS 7YPE OF WORK WILL BE COMPLETED WITH <br /> WHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOFApERMITDOE5N0T. <br /> �oT� e�ocK� oF � PRESUME TO GIVE AUTHORINTO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE OWNER OF <br /> THIS PpOPERNTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> r ,� AND I COMPLy WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> �h (�� '/LIN4 �O + ,Q - Q� � 296200WAC. . <br /> .SX Qj� r SIGNqTUREOFCONTRRCTORORpUTMOq12 AGENT OATE <br /> r �_ ��� � <br /> PpQ1ECTRDDRE55 —� 4-3a- 43 <br /> , ///�� � r APPIICANTSGTYBU5INE SLICENSENO.ANOBUSINESSNAME <br /> 2 ! <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTUpE OR ITEM FEE NO. 7YPE OF E�UIPMENT FEE <br /> WATER CLOSEf(TOILE'T) A/C—lVHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—&T.U. M EA <br /> LAVATORY(WASH BASIN) UNIT HEATERS—&T.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV WATERHEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SEFVICE—BAR,EfC.) <br /> I <br /> SUBTOTAL S SUBTOTAL $ <br /> PERMIT $ <br /> PERMIT g <br /> TOTAL FEE $ TOTAL FEE $ <br /> FPONTSETBACK REARSETBACK SIOESETBA(;K PIANCNECNNUMBEP FEE RECEIPfNO. <br /> usezoNe iaTaqen VpCANTSITE FEES VALUATION FEE <br /> u ves ❑ No <br /> ttPEOFCONST. OCCUPANCYGROUP NOOFDWEILINCUNITS BUILDING <br /> ALLOWpBLE/RCTURL _ <br /> PL UMBING <br /> 512E OF OLOG. NO OF STOFIES &SMT. OGG LOnD <br /> �Y MECHANICAI <br /> ❑N <br /> HEIGNTLIMITRiION OTHER <br /> FIRESPRINKLERS REOUiRED ❑Y:S ❑ NO I STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> r1PPUCRTION FCG BY PLqNS APPR.BV <br /> �� I PUBLIC WORKS <br /> � ZI � �/P�( TOTAL <br />