Laserfiche WebLink
��''� everetl <br /> pppLIGATIOi. FO�i CONSTRUCTI..�N PERMI'T � <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> tlro Evnyrann <br /> ciTv or <br /> everett HEATINGSYSTEM: UGAS �ELECTRIC ❑ _—___ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> �r � DEMOLITION COMBINATION ,�BUILDING MECHANICAL � PLUMBING SIGN <br /> ts1 FIAllA00�E55 Utt T.iP y4''JOS PHUNE <br /> � y ownen �.j' __ <br /> �1/�S-���GY�9-�Cti�TI'Z f%/.o,E�rt� �' .� �5- C' 23 - <br /> -� ~ MNL�DORE55� CITY Z6' PMONE <br /> 'y 1x-] (A LENANi __ <br /> ~I Z� G�� � /q�J�" ���n CGiv a��oN� <br /> H �RCNIIEGTO DESIGNEN M�I DDPE55 ���� � <br /> `� H z � �L� ����7`/�� <br /> �G[NEIIALCONiRRCTCR AIAILR�D�ESS GIiV 21P /� PHONE LICENSF.i <br /> '� � H „rQ�H �rnc92e�'. dh'Q�*o 95t1 K <br /> ��� EL'nnNiCALCONIRALiUFl MA�LADDFE55 GTV ZIP PHOYE UCENSE <br /> Q H PLUMOM LONTNACLOF MAILADDRESS <br /> CiiY ZiP PMONE LICENSE� <br /> �n /�/q <br /> � � L1A55�F ORM N <br /> � y� xNEW i. � ADDITION . � ALTERATION . � REPAIR � DEMOLITION . �. WOODSTOVE/F{iPL INSERT � BUILOING RELOCATION <br /> Ju�cd plQw ���eppprkrJn �NfAGrTPEP504RNDGMONENO <br /> (~�J y CONTMCi PRICE OF WOI1N .�(� ` ` P N �L 3 3 � -iG � 9 <br /> �"� �ESI:FiBE WORK AND SOUAf1E FOOTAGE INVOL EO / <br /> CC�,� G�+ �n �..jy�ry� � !�M, l�tt�i�� / { <br /> 3 C+7 t' �Ppo�`�SEp��o��p��y��� � I HEREBV CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br /> ��� C�� � APPLICATION AND KN01N THE SAME TO BE TRUE AN�CORRECT.ALL <br /> y O f/) S���n�� PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS TYPE OF <br /> �ec�ioesen�anor+oranoven—rv��sNp��+r+ee�owoAnrrna�FouRcovies� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> .�t e�ocK �(L._ cF _ NOT. THE GRANTING OF A PERMIT DOES NOi PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � �_ � ( ` � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> _17_L � PERFORMANCE OF CO�JSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ��) /� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH I <br /> qPPIICATION IS MADE AND I COAIPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND'196200 WAC. <br /> �T �( r�J f 1 i . 7 _ _ SiGNATUR[OF CCNTRAGIOR OR AUTHOR2ED AGENT DRTE � <br /> Y1"' .7`1.7 <br /> PfiOJECt AD RE55 '�.yJ�L�r`rJJ)�/ /�/�(,�(�7Iz �I f'���v v 4 � I <br /> G �/� Q� FPPUCANTSCITVBUSINESSLICRISENOANDOUSINESSNRME I <br /> � PLUMBING MECHANICAL I <br /> /� -� NO. TYPE OF EQUIPMENT FEE � <br /> IN0. TYPE OF FIXTURE OR ITEM FEE <br /> C�i WATER CLOSET(TOILET) A/CrA/HNDLG UNITS—H P. <br /> � BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � � _ LAVhTORY(WASH BASIN) UNIT HEHTERS—B.T.U. M I� <br /> '�� � _ SHOWER CLOTHES DRYERS <br /> ' �I KITCHEN SINK 8 DISP VENTILATION FAN <br /> ' � FANGEHOOD � <br /> DISHWASHEF <br /> � LAUNDRYTRAY WATER HEATER <br /> �� '�_ CLOTHES WASHER � WOOD STOVE , <br /> I �=� URINAL � METAL FIREPLACE 8 CHIMNEY i <br /> DRINKING FOUNTAIN _ FIREPLACE INSERT <br /> FLOGR DRAIN HEAT PUMP ' ' <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADEFS � EXHAUST FAN �I <br /> � � SINK(SERVICE—BAR,ETC.1 I I <br /> � L('�� � <br /> i '�,~� <br /> ' SUB TOTAL 5 SUB TOTAL $ <br /> I � PER611T 5 PERMIT S <br /> � � TOTAIFEE S ;C TOTALFEE 5 � <br /> �1� i <br /> FOR OFFICE USE ONLY: <br /> PI�NCH[CNN 4 f iEF. BECEiP NO <br /> FRONiS[TBAGN � R[AfISEi(1nLrc ' Si0[5[T�K ���r_ 2a• ���!/JG'��/1 <br /> ^ � �7 V �� <br /> SJ <br /> usE� �o�AA�^ vacnrrtsnr FEES VALUATION FEE <br /> -Z ^�S c�o - Y� a���o��,� � -Zo l3 s� <br /> i»f Of LONiS AILOWABIE IYPE C`fON51 4CNAl «L,.,�r,•`u no av.vnva.=ur��5 <br /> � _ � — PWA181NG I <br /> SIIt JF BLUG. NO.OF STOR�ES B EMENT I.IEGHAIUCAL <br /> � to '25F �o � <br /> ADDITIONAL PLAN CMECN � <br /> P'.COPNICYLO�O flRESPRNNLEfl511E09 NEIGHTIiMit�TION _— <br /> N� N, � OTHER <br /> 6LASONFORSPRINNLEHS � �� <br /> STATE BWIDING SURCliARGE <br /> rtliqNE9Y PlANSRPPROVE00Y CITY OF EVERETT PWUC WORN$ �G i <br /> �� LOCAL SALES � � q SG <br /> 5�� TAl(COOE IS 3105 TOTAL <br />