Laserfiche WebLink
APPLICATIOrI FOR CONSTRUCT��JN PERMIT <br /> everett <br /> «��.E��,�4���� e <br /> I CITV OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 ���HANICAL ' PLUMBING SIGN <br /> DEMOLITION C^- '��BINATION ` BUILDING <br /> O\VNER MAILA�ORE55 � QTY ZIP PHONE i � �� _ )^ JC� <br /> ...aaa i�n �-rrp n�i n� - ysa I Cre�,c� ,t+ �-`'u`�,Lu�� ��-r�� <br /> � ~ � Cltt 21P PMONE <br /> � IENI,NT / MAIL�DDRE55 <br /> � � " ��/ CITY ZIP PHONE <br /> y � y PRLHITECiORDE5IGNER M4ILADDRE55 <br /> r <br /> M PHONE LICE $AI � <br /> y � GT.ryERAL�NTR�TOR ��55 �� � ,� <br /> O CC O 1 �'�.C��i i � 1 c��-r��l P��f - a��i-S��- U I�A'C� � <br /> � y M ��n, Z�p PHONE LICENSE <br /> �] IdECMANIC�L CO RACTOR M Il ADORESS y�3� <br /> �S 't � PNONE LICENSE� <br /> � y . CITY 21P <br /> PWMB�NuGONiPPGTOH MAILP�DRE55 <br /> N C�9 � <br /> CLASS OF WORN <br /> � . , ' I <br /> � y �. �. NEW ��, � ADDITION IWALTERATION f J REPAIR i_'� DEMOLITION �..1 WOODSTOVE/FRPL INSERT '�-1 BUILDING RELOCATI <br /> � � y CONTACTPERSONANDPHONENO. <br /> T[NANT IM1IPROVENENT Ofl INT IOR REMODEL ONL`{ <br /> l.j <br /> N � CONTPACiPRICEOFWORK:� �' <br /> q DESCRIBE WORK qN 5 F,F,1E FOOTAiE IN OLVED ���� <br /> T t�V C� . L . w " <br /> y O �jj PROOO5E0U5EOF6UIlDMu �,,�/\ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> F� �: l� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEGRLOESCRIPT10NOFPROPERTY�SMOWNBEIOWORATTACMFOURGOPiES) PROVISIONSOFLAWSANDORDINANCESGOVERNING7HISNPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT B�aK �F AUTHOFI VRTO VIOLA�TEAOR CANCEL THE PROVESIONS OF AINY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTf!rJRIZE7 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORri �UR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGN4TURE0FCONTfiACTORORAUiMOR2EDAGENT �ATE <br /> //l _ ^ � - <br /> � � ���ti �� � <br /> PROIEC�D�55 /�i������ � pppLIC�N SCITYGUSit SSLICENSE .ANOOUSMESSNAME <br /> / � <br /> / � ` MECHANIC�! <br /> I . PLUMBING - FEE <br /> �� N0. TYPE OF FIXTURE OR ITEM FEE NO. IYPE OF E�UIPMENT <br /> WATEF CLOSET(TOILET) AiC-0.�HND�G UNITS—H.P. <br /> 1 BATHTUB FORCED AIR>YSTEMS—B.LU M E.A � <br /> UNIT HEATERS—B.T.U. M ' <br /> �� LAVATOFY(WASH BASIN) —`— <br /> . �� SHOWER CLOTHES DRYERS � <br /> � KITCHEN SINK&DISP VENTILATION FAN <br /> RANGEHOOD <br /> DISHWASHER � <br /> , 1r� LAUNGRY TRAY ' WATER HEATER � <br /> . I �� CLOTHES WASHER WOOD STOVE ' <br /> URINAL METAL FIREPLACE 8 CHIMNEV ' <br /> DRINKINCa FOUNTAIN i FIREPLACE INSERT �� <br /> HEAT PUMP <br /> � FLOOR�RAIN G��S PIPING <br /> �I�I BACKFLOW PREVE�ITERS EXh1.1UST FAN <br /> ROOF DRAINS—RAINLEADERS . ��r-�� n , � L'J� <br /> SWK(SERVICE—BAR.ETC.) � <br /> , � t�i ; � <br /> �� _ � ' <br /> I ' <br /> t SUBTOTAL 5 ' U <br /> SUB TOTAL $ pERM1T S <br /> PERMIT S TOTAL FEE S SS'O <br /> l �'1� TOTAL FEE 5 <br /> � PIANCHEGKNUMOER FEE REGEIPTNO. <br /> FRONT SETBRCK PERR SETBAGK SIDE SETBACK <br /> FEES VALUATION FEE <br /> USE20NE LOTRREA VRCANTSRE � <br /> f�'. Y[S ❑ NO BUILOMG � <br /> occurauv xo amv[uixcuxns ' <br /> ' MEOFCONSi.AIIOWABIE IYPEOFCONSiAGiU�L �qouv � <br /> PLUMB�NG ' <br /> � SIZEOFOLDG. NOAFSTORIES UnSEMENT MECHANICAL `S� o0 <br /> l � YES �. I NO i <br /> I pLCUPANGYIOAD FIPESPflNNLERSFEO'D HEIGHTIIMIiRTION <br /> OTHER ' <br /> I . I 1 YES �7 NO STATE BUILDING SURCMARGE � <br /> � REASONFORSPRINNLEFS $TATEENEflGVSURCHARGE � <br /> � pFPUrpTiONALC.OY PUNSAPPROYEOBY ��TyOFEVERETT PUBUCWORK$ � <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL S '1� <br />