Laserfiche WebLink
� y <br />a�� <br />,�,� Hm �A <br />Hxi-�i <br />�oH7�tl <br />71H� <br />N <br />x <br />H <br />o�e <br />��g <br />�jiY (] <br />t"y� <br />NH <br />gyH <br />� � y <br />HO�N <br />APPLICATION FOR CONSTRUCTIvN PERMIT e�e�P�t <br />e� <br />I�o Everg�een TO BE COMPLETED IN INK—PLEASE PRINT <br />CITV OF <br />everett HEATING SYSTEM: ❑ GAS ELECTRIC ❑ i <br />BUILDING DEPARTMENT <br />'" 259•8810 <br />` 1 DEMOLITION xCOMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNEP MAILAO�RESS CIiY ZIP PHONE � <br />P�II��Jou�itc,� 3�Jd7 ���- st G�%�c�TT qS�:xi � ��'7 -i'7�/ <br />TENANT MAiL AODRE55 CITV ZIP PHONE <br />MFIL PUUH[55 <br />MAIL �� <br />PWMBMGCONTRACTOR MNLApDRE55 <br />CLA55 0: CORN <br />1�NEW �. � ADDITION . ' ALTERATION <br />CONTRACTPRiCEOFWOR6 L�(_/�.�(/C <br />DESGRiBE WOFK A SOUANE FOOTAGE INVOIVED <br />A'%fsl.c) �FL��' �/� <br />Pq0 E�OSEOFBWL�WG <br />%��iUTl� L. <br />IEGAL OESCRIPTION OF PqOPERiY �SNOWN BELOW OR Rl <br />( <br />LOT�_ _ BIOCK �_ OF _e� <br />:CJECTR��PE55 <br />.s%a% i/✓.l1 <br />PLUMBING <br />NO. TYPE OF FIXI <br />WATEfl CLOSET�TOII <br />BATHTUB <br />LAVATORY�WASH BA <br />SHOWER <br />KITCHEN SINK 8 DISF <br />DISHWASHEF <br />LAUNDFVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINI(ING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN'�� <br />ROOF DRAINS—RAIN <br />SINK ISERVICE—BAR <br />CITY <br />LIY Yf1VliC <br />��y �s� -��C'�D <br />21P VHONE LICENSE� <br />iu2(')•� � ��/'�%�y ✓fAes <br />ZiP PNONE LICENSE / <br />ZIP PHONE LICENSE < <br />.��. FEPAIR .. DEMOLITION �. I WOODSTOVEiFRPL INSER! `; BUILDING RELOCATION <br />I CONTACT PERSON RND PHONE N0. _ <br />�i <br />COPIES� <br />�L�/�iipC ST. <br />E OR ITEM FEE <br />FOR OFFICE USE ONLY: <br />fRONT SETBACK RERR SETBACN <br />7.r1 w <br />USEZONE IOTAflEA <br />treeoreorvis nuowaeie <br />/�' /� <br />SIZE OF BLDG <br />u r 4 US <br />OGGUPANCYLOAD <br />n//A <br />RE450NFORSPRNKLEFS <br />INTANE BV <br />1""�v ` <br />SUB TO <br />PERMIT <br />iYPE Of COfl9. ACNAL <br />�/ - ✓ <br />NO. OF S�T1OFIES <br />FIRE SPPNNlENS REOD <br />N�/ <br />P�ANS APPROVE� BY <br />�� <br />I HEREBY CERTiFY THAT I HAVE HEAD AND EXAMINE� THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY , <br />OTHER STATE OR LOCAL LAW REGULATING CONSTqUCTION OR THE �I <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED RY THE �, <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH ' <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE �, <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAQ � � <br />SIGNRTUREOFCONTRPGTORORRUTHOR2EDr1GEN1 OATE � /s�/1 � <br />U <br />X � <br />APPLIGANTS�� �LILENSE NO. RN� BUSINE�N/ 1.1E <br />NO. I TVPE OF EOUIPMENT � FEE <br />)p UNITHEATEPS—B.T.U. M <br />/G ' CLOTHES DflVERS <br />/o � VENTILATION FAN <br />/O RANGE HOOD <br />' ' WATER HEATER <br />"p � WOOD STOVE <br />METAL FIREPLACE 8 CHIMI <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />� EXHAUSTFAN <br />$IOE SETBACN PLAN LMECN NUMtltN <br />S' ' 2 <br />VACRNT SITE FEES <br />GS BUILDING <br />p[�Jvnrb NOIXo-n'4uxLcbrtS <br />°q1 Z pwn+eiuc <br />�� <br />oa5ElnENr MECHANIC.4L <br />N� <br />IIEIGHT uralia�toN AOOIIIONAI PIAN CHECH <br />� O7HEF <br />STATE BUILDING SURCHARGE <br />CITY OF EVEqETT PUDLIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 TaTA� <br />M <br />i <br />SUBTOTAL S /YO ; <br />PERMIT 5 <br />TOTAL FEE S /20 �. -- <br />FEE J HECEIPTNO. <br />�C <br />O� <br />O � <br />U� <br />