Laserfiche WebLink
DEry�o /� tio�v P�rm, t <br />' APPLIC�. �ION FOR CONSTR4�TION <br />� PERMIT <br />fh� Ewrprs�n <br />CITY OF � everett <br />everett e <br />BUILDINO DEPAfiTMENT <br />259•8810 TO BE COMPLETED IN INK — PLEASE PRINT <br />ER M�I� �OOflE93 LITY 21P PHONE <br />1�.�,,.,/.�e Cl.in// /I�nf'.nid�ii h�42S /22.,va .a,1.3�. P.UP.rPHG/�.9B,7a9 337030/ <br />MCXRECTOflDE810NER M�ILAOORE55 CITY z�P PMONE <br />PLUM&NOCONTMCfOX MAILAOOPE55 CITY ZIP PHONE LICEN9E• <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINORELOCATION <br />CONTMCTPRICEOF WOf1K <br />DEBCflIBE WORK �ND 80UARE FOOTAUE �NVOWEO <br />��`�-t�"' � <br />9EOFBU DI 0 <br />� LEd1LD�Pf10PERTYI9MOWN8ELOV/OR�TTI�CMFOOHGOPIE9� <br />LOT� KOCKf2LL OF P�Q / D� SLSf4LLLC <br />A�L//S/OA/ ~� �� <br />WiOJECTADDPESS <br />� ,29zS� F��/fra/, f_�/i, /.,�i <br />PLUMBING <br />.. NO. 7YPE OF FI%TURE OR ITEM <br />' WATERCL09EfITOILEq <br />BATHNB <br />UVATORV (WASH BASIM <br />SHOWER <br />KITCHEN EINKd DISP. <br />�� DI9HWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOH DRAIN <br />BACKFIOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK(SERVICE— BAR. ETC.) <br />SUBTOTAL E <br />PERMIT S <br />TOTAL FEE S <br />iRONTSETBACN PEAPSETBACK SIDESETBI�CK <br />USE20NE LOTANEA V�CANTSITE <br />0 YES ❑ NO <br />ttPEOFCONST. OCCUPANGYaROUP NOAF�WELIII <br />ALLOWABLE/ACTU�L <br />SIZEOFBLDQ NO.OFSTOPIES BSMT. OGGIOAD <br />❑Y <br />❑N <br />NEIGNT LIMITAT <br />FIRE BP111NKLER9 REOUIREO ❑ YES ❑ NO <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED TMIS APPLICATION AND <br />KNOW THE 9AME TO BE TRUE AND CORRECT, ALL PROV1910N3OF LAWB AND <br />ORDINANCES OOVERNINO THI9 TVPE OF WORK WILL BE CAMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT.THEQRANTIN60FA PERMITDOES NOT <br />PRE3UME TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVI910NB OF <br />ANV OTHEH STATE OR IOCAL LAW REOULATINQ CAN9TRUCTION ORTFIE PEIF <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2E0 BV TME OWNER OF <br />THIS PROPEFTY TO PERFORM THE WORK FOR WHICH APPLICATION IR MADE <br />AND I COMPLV WITH THE 9TATE CONTRACTORS LAW 1827 RCW AND <br />2982Q7 .':AG <br />SIONRUNEOFCONTR/�CTOROR�UTHORREDA6ENT D�TE <br />X �,,.,v�'� S�'J�`,��,.� �/ /i� <br />APPLICIINTS YBIISINES LICENS NO.ANOBUSINE59N�MfT— <br />� <br />MECMANICAL <br />NO. TYPEOFEOUIPM! <br />/VC — A/HNDLG UNITS — H.P. <br />fORCED AIR SVSTEMS— flT.U. <br />UNITHEATERS—B,T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />fIREPLACEINSERT <br />HEAT PUMP <br />OAS PIP�NG <br />EXHAUSTFAN <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDINCa SUFCHARCaE <br />STATE ENER6Y SURCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />a <br />�: m. <br />t <br />