Laserfiche WebLink
APP�IC�i`��fION FQR CONSTR��TION <br /> PERMIT <br /> ths Ererpreen <br /> CITV OF <br /> evcrett <br /> everett e <br /> BUILDING DEPARTMENT <br /> 2Fg•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAI��UORE55 CIIY ZIP PIIONE <br /> A �,,..,I 1LY` ��J �� nn � (� <br /> TENA�\Ll.1.NT�l J/�+�J��l`�RILRD�RESS r I���F�I1X_t\ Z1� \ �' <br /> CIIY PHONE <br /> �RCNITEGTOFDESIQNER MAI��OOPE55 <br /> CItY ZIP PNONE <br /> OENER�LGONiRAGiOfl M�ILADORE55 CITY ZIP PIIO�E <br /> LICENSE• <br /> MECH�NI�CONTHAGTOfl MAILAUORE55 PHONE <br /> �".��_/I_�� � �n)�,�y� �/� �7 //�� � [� UCE�N1S/E• <br /> 7Zf fF�Y/I( X� �//J� � �J /o�� ir���.--v_..� '_�S`��C� �Cll �J <br /> PLUMBINp T TOH MAIL� Of1E55 � CIIY ZI� �ONE <br /> IIf,EN9E� <br /> F �'C'��l�Ari'F ��� I-��7CK�_ <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION LK WpODSiOVE/FRPLINSERT ❑ BUILDINGRELOCA710N <br /> TENMlT IMPRDVEMENT OR INTEHIOq REMO�EL ONLY CONTACT FEtI50N ANO PMONE NO <br /> CONTRAGTPPICEOFWpqR ��{�,M �f��,�y2 ZS, _GL�� <br /> DE�CRIDE V/OPI(1ND SpUN1E FOOT�OE INVpWED <br /> P09 UlEOFBVILOINO <br /> GaC� I HEFEBY CERTIFY THAT 1 HAVE READ AND EXAMINED iHIS APPLICqTION AND <br /> <.�r KNOW THE SAME TO BE TRUE AND CORqECT.ALL PROVISIONS OF LqWS AND <br /> LEd1LDESGRIPTIONOF PppP[qry�gNOWN BELOW ORAR�CH FOURCOMES� ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLE7Ep WITH <br /> WHETHERSPECIFIEDHEREINORNOT.THEORANTINQOFAPEHMITDOESNOT i <br /> LOi e�oCK OF PFESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR iHE PEH- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> THIS PROPERN TO PERFORM iHE WORK FOR WHICH APPLICAT�ON IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AN� <br /> 296.200 WAG <br /> SIGNqUREOFCONIRAC70RORN1INORIZED ENT DRE <br /> X <br /> NpJECTA00FE59 <br /> �P �N 9CIfYBU5WE5 ll SENQ�NDBUS� N�ME ��_ <br /> � <br /> � PLUMBINO MECHANICAL � <br /> NO. TYPE OF FIXTUqE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSEf(TOILEI) A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB FOFCED AIR SYSTEMS—6T.U. M EA � <br /> LAVATORY(WASHBASIN) UNI7l1EATERS—flT.U. M <br /> 9HOWER CLOTHESORYERS � <br /> KITCHEN SINKB DISP. VENTILATION FAN �� <br /> DI9HWA3HER RANOE HOOD � <br /> LAUNDRYTFAY WATER HEATER <br /> CLOiHES WASHER WOOD STOVE <br /> � URINAL <br /> METAL FIREPLACE d CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACEINSERT <br /> � � FLOOR DRAIN L'EAT PUMP <br /> � BACKFLOW PqEVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> 1 <br /> 1� <br /> I SUBTOTAL S SUBTOTAL S <br /> � PERMIT E PERMIT S <br /> TOTAL FEE S TOTAL FEE y <br /> FNONT9ETBI�CK PEAqgEiB/�CK 91DESETBRGN PIANCNECKNUMBEN FEE <br /> RECEIPf NO. <br /> 1 <br /> � U9EZONE IOTANEA WWNi51IE <br /> o vE9 ❑No FEES VALUATION FEE <br /> 1 TYPEOFCON57. OCCUF�NCYGROUP NO.OFOWELLINOUNIIS BUILDING <br /> QIOW�BLE/AQU�L <br /> PLUMBING <br /> B12EOFBlDQ NOOFSiORIES BSMf. OGGIORD <br /> o v MECHANICAL <br /> ❑ N <br /> NEIGHTLIMIfRT10N OTHER <br /> FIRESPRINI(IERSHEWIREO OYES ONO <br />� STATE BUIL�IN(3 SURCHARGE <br />� STATE ENERGY SURCHARGE <br />'1 IPPLIQTION�CpBY PUN9APPR.BY .___ <br />� PUBLIC WORKS . <br />' __ TOTAL I <br />� <br />� <br /> � <br />