Laserfiche WebLink
APPLICATIOrvI FOR CONSTRUCTIJId PERMIT <br /> everetl <br /> �,.,.�.�„9,��.,, e <br /> Q7Y OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> DEMOLITION ! i COMBINATION BUILDING ECHANICAL PLUMBING SIGN <br /> OV.. � <br /> MRIL O�RE56 � ITY t�P �9 �'�� �� � �� � <br /> � +�n-I�, �c+=� d�'1� 7 �� �N - ����! (.��,v� r►; � a �1; i <br /> � � � GITY ZIP PHONE <br /> VO �1 y T[N�NT ((� ILADDflE55 — <br /> 10 A 61 <br /> �' "3 y �RCHITEGTOFDEEiGNER MARRDDRE55 GTY ZIP PHONE <br /> •] � H <br /> K n ENEFALC�NTRACTOR M CRY 21P PNONE LIGENSE• <br /> � �, VALLEY f1h19�b`LS GAC, INC. <br /> n7 N n] �� ��*J-J.3&--JY� <br /> t!! M M[CMANICRICONTFACTOR I AD[1RE55 CIN ZIP PHONE LICENSEI <br /> y � 2��5 A1cDouP•all <br /> �p � Fveraitrl"1as�inQton�82f)i <br /> PLNd01N�CONTRFCTOIi h1�ILA00RES5 CI7Y 21P PHONE LICENSE• <br /> M � � <br /> G) ` R ��q550F WOFK �� ' <br /> �M � <br /> H . NEW I ADDITIONxSTERATION .�.` REPAIR '. DEMOLITION i ' WOODSTOV6FRPL INSERT �, BUILDING RELOCA <br /> y LONTACT PERSON PND PMONE NO. <br /> y � TENANTIMPROVEMENTORINTERIOflRE¢1OOELONY <br /> Q4 CONTRACTPRICEOFWORK: ���1 �D <br /> ,J d y DESCRIBE PKANDSOUA FOOTAGEIydYED <br /> "� LE t� � .��� � / /2� <br /> � H N PROPOSEDUSEOFBUiIDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> H O m � � pPPLICAT10N AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �� PROVISIONS OF L�WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPiIONOFPFOPERTY�SMOWN9ElOWORATTALM=OURGOPIES� yyORK WILL BE COMPLETED WITH WHETHFR SPECIFIED HEREIN OR <br /> tor a�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br /> SIGNATUPEOFCONTPACTOPORAUiNOR2E0lGENT OAT[ <br /> X � n �,�, + ^ <br /> l�l�K-' � niIiILIIY '�`�L. � <br /> PRQIECTRDORESS \�-Q�,' `rI „1 �`�-+ qpp�iCRNTSCITVBU51NE55lICENSEN .rWDBU5ME55N4ME <br /> � V I/` Y <br /> I��� � PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) � NC—A/HNDLG UNITS—H.P. ' <br /> 1 BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> �� LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M � <br /> � '��' SHOWER � CLOTHESDRYERS ' <br /> �� ' KITCHEN SINK 8 DISP _ VENTILATION FAN <br /> � DISHWASHER RANG�HOOD <br /> LAUNDRY TRAV WATER HEATER � <br /> I �� � CLOTHES WASHER � WOOD STOVE ' <br /> � METAL FIREPLACE 8 CHIMNEY <br /> URINAL � <br /> DRINICING FOUNTAIN FIREPLAGE INSERT � <br /> �� FLOOR DRAIN i_ ` HEAT PUMP i <br /> !�' BAGKFLGW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADEiiS � E%HAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � =� �- � � <br /> • 'f�_ � <br /> �= � <br /> � � - ' 1 <br /> SUBTOTAL 5 ' SUBTOTAL 5 `� ' — <br /> II '1t 1, PERMIT 5 � PERMIT 5 S� — <br /> �� TOTALFEE S ' TOTALFEE 5 S' ' <br /> - PLANCNEGKNUMBER FEE RECEIPTNO. <br /> FRONTSETORCH RCARSETBRCK SID[SETBRCK <br /> USE20NE LOTAflEA <br /> VRCANTSITE F�ES VALUATION FEE <br /> [-' YES `i NO BUILDING <br /> 7YPEOFCONST.AIIOWABIE 1VPEOiLON51.ACNAL McuP�xcr xoaowulin4uvn5 � <br /> GBp�'1P PI.UMBING <br /> � <br /> SREOFOIDG. NO.OFSI0RIE5 OASEMENT MECHANICAL � <br /> ; ! YES '� ` NO <br /> — OTHER ' <br /> . OCCUPANCYlORO FIflESPRNNLER5RE0'D HEIGHTIiMIT�TION <br /> ' f! YES .-'� NO STATE BUILOING SURCHARGE � <br /> REASON FOF SPPINNLEPS � <br /> STATEENERGYSURCHARGE <br /> APPUGATION ACC.DY PLANS APPROVED DY CITY OF EVEflETT PUBLIC W�RK$ <br /> LOCAL SALES �r�; � <br /> TAX CODE IS 3105 TOTAL <br />