Laserfiche WebLink
�►PPLICATIO►. FOR COI�l�TR4lCTI.rN PERMIT �'`�'"'" <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> . ��.,,,,,,._ <br /> CI7 Y OF _—_— <br /> everett ( HEATING SYSTEM ❑GAS U ELECTFIC U ___—_--� <br /> BUILDING DEPARTMENT <br /> 259-�10 <br /> ( 'DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> �y r �L �� G p:iP p� PHONE <br /> N (11}'NLii AIAI�A���[�5 � I /� Y S 1 `� ( J I �O <br /> 7 ��3 � p <br /> � P 'L V�� c� COIULG��O PMONE � , 1� O S.� <br /> b � m ��� �., "'"��R�/'�} ��--7 �'� ��Zu� � 3 5 7 <br /> � y y /�l i G�n..a� � /� � PHONE <br /> AqCHRECTOR0E51GNEP MRILAD�RESS <br /> r.ITv ZiP <br /> K ��] (~j ��TY Z�p PHONE IILENSE� <br /> f) W O GC'�EFRLf,ONTBAGTOR AIAILADDIiE55 <br /> � N 1�-� <br /> � � ��n. Z�p PHONE IICENSE t <br /> � Ai[O�ANICALGONiRRGTOP MRILADDRE55 <br /> (C O — <br /> y ��T� Z�p PNONE LICENSE I <br /> p 1`Wb�01NGCONTP�CTOR MAILADURE55 <br /> M [�V O <br /> C1 • f� <br /> ~ CL�SSOFWORK � ' <br /> �,'� �d NEW �. ACDITION . ALTEFATION REPAiF .��MOLITION . WOODSTOVE/FRPL INSERT � BUILDING FELOCATION <br /> H LONiAGT PEPSON PNO PNONE N0. <br /> N <br /> � y GONTRACT PRICE OF WORN <br /> � � �y ESCRIBE WORK A SOU�RE Fpp/TJr�[INV/OL�VED L�O S ,� � <br /> y Oj QlVI V'q•`nG t <br /> o y �oP s ous�o�ILDING I HEREBV CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> imn�oeser+iario ERtt(SHOWNOELOW OR AT1ACM FouacoPies� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IC r7x���� �'� ��/ J�„5(— .�_� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i�r S e�acrc oF �1 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> / p AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��IC Y / / /// �'/��`l OTHEF STATE OR LOCAL LAW REGULATING CCNSTRUCTION OR THE <br /> PERFORMANCE OF CONSTIIUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPEFTY TO PERFORA7 THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATIIREOFCONTPAGTORORAOiHORRED�GENT �ATE <br /> X �� � il 2. / � / <br /> PRQI[CTAODRESs pPPLtCANTSCITYBUSMESSIiCEN5EN0.ANDOUSINE55N E <br /> �3 D 7 � o �k Iti�� c � ti <br /> I �� PLUMBING MECHANICAI <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 1 ' _ WA7eR CLOSE7(TOILE7) A�C—AMNDLG UNITS—H.R ; <br /> '�� BATHTUB FOHCED AIR SYSTEMS—B.T.U. _ M E.A. <br /> �I LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHW�SHER RANGE HJOD <br /> . I _ LAUNDRVTRAY WATER HEATER <br /> �� WOOD STOVE <br /> CLOTNES WASHER <br /> URINAL METAL FIREPLACE 8 CHIMNEI' <br /> DRINKING FOUNTAIN i FIREPLACE INSERT �� <br /> , I_1�' FLOOR DRAIN HEAT PUMP <br /> I BACKFLOW FREVENTERS ; GAS PIPING <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> � ' SINK(SERVICE—BAR,ETC.1 _�— � <br /> 1, � . • <br /> I <br /> SU�TOTAL $ SUB TOTAL S <br /> ��� PERMIT 5 PERMIT S _ <br /> �. TOTAL FEE $ � �x TOTAL FEE S <br /> FOR OFFICE USE ONLY: aeceiar no <br /> FItONT5EID4CN REARSETOACK SIGESETO�CN PLFNCNECKNUI.IUf'R FEE <br /> US[ZONE IOiARE� VACRNTSITE FEES VALUATION FEE <br /> BUILDM(i <br /> IVPEOfCONIS.ALIOWABIE iYPEOiGON9.ACI0PL otGqpp[r NomVxuuu�^Ns <br /> PLUMBING <br /> SiZEOFBLDG. NO.OFSTORIES BRSEMENT MECHANICAL <br /> OGCUPANCYlOAD FIRESPRNKLEHSREO'D HEIGHTLIMrtpTION AD�ITIONALPLANCHECK � <br /> OTHER <br /> �— <br /> RE�SON FOR SPf11NNlERS ��� <br /> STATE BUIIDING SURCHARGE <br /> � <br /> �r,�nki n7 a�n�u nrrnoveoov CITY OF EVERETT PUDLIC WORKS <br /> LOCAL SALES // � <br /> TAX CODE IS 3105 rorn� y � C� <br />