Laserfiche WebLink
pPPLIGr�T10N�FE RUC',ONS�I�uCI'iON <br /> ,•��•���u <br /> fha EvarBreon � <br /> GTY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK— PLEASE PRINT <br /> 259-8810 <br /> / vnor+tI f/� ./ <br /> y o�HCA ((�� r I_ I��^o�EssL�� L/LX�.L�(� i-'�1"'!� z�-�. r�`-fC1-�� / <br /> {L r �9 � �LW=1 V���ll�� L� GiY `, — <br /> 2 <br /> N 4a }E y4\NT MAILA��flE55 <br /> 10 A � 1�`�r�- PNONE <br /> c y y �J C�iY 21P <br /> b [L A(iCM11ELLOR0E51�NEA MAILRDORE55 <br /> M �9 M Zip /� P110NE UCENSE• <br /> � L MRIL��55�� � � Liiv, _ ^ ' ��/(� /' i'� <br /> H 'l7A °, Ery _ENA�� Tpa�Toa�y �f���% C./l �C� � �-� p�� _ <br /> � N M �`.� QLV ZIV PIION ^ LIGENSL• <br /> MEGIIANIGALGONiqAp10H MAILAD�RE55 1 1 �,^I� J�rj f � L �/�i L�/ <br /> .� � � v �w�v J�i�� J <br /> PLUMBING60NIR�LTOR MUL�ODPE55 <br /> crtr ziv rH e uccrvsc• <br /> O H <br /> F n O - <br /> � `� R ��ASSOFWOAN <br /> y ❑ NEW ❑ AODITION LTERATION ❑ REPAIR ❑ DEMOLITION COOACTOODON�PN�P onENN�ERT ❑ BUIIDINGRELOCATION <br /> � � � TENPNiIMPROVEMENiON�Ht RIORPE^,00ELO;�I� ' <br /> h �� � <br /> �Q7 y % �/5, L. <br /> f�y)' d N p SG1RIBEyy�HI�C�EONF�OUK E`�i`p.GEINVOLVEO <br /> �{ � � ✓ ,�Cv `� -� ��' V � � �� _�—_— <br /> H O U. PPOPOSEOUSEOFBUILD a � IHEREBVGERTIFYTHATIHAVEREADANDE%AMINE�THISAPPLICATIONAND <br /> KNOWTHESAMETOBETRUEANDCOARECT.ALLPROVISIONSOFLAWSAND <br /> � ORDINANCES GOVERNING THIS n'PE OF WORK WILL 9E COMPLETED WITH <br /> IEYAL0E5GFIP:IONOFPPOPERTYISNOWNBELOW�R�TUCNFOUNGOVIE51 WHETHERSPECIPIEDHEREINORNOT.THEGRANTINGOFAPER1.11TDOESNOT <br /> PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> �pT B�OtK OF ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUC110N.THAT I AM AUTHORIZEO BY THE OWNER OF <br /> ANID PROOMPLYTWIIHRTNEMSTA EWCONTRAC ORS'{LAWL1827OAC YMAND <br /> 2�J6200 WAC. <br /> SIGYALU�[O�WNiR<C10t10FAt11110RIZEDAG[NL �RiC <br /> X���. ��-��,� - <br /> VROJEGTA�ORE55 ^� APPL�,ANTSGiY0U514 SLIGENSENOAN�BUSINESSNAME <br /> � �� � �' <br /> MECHANICAL <br /> PLUMBING FEE <br /> �� FEE NO. TYPE OF E�UIPMENT <br /> I l��. qp, TYPEOFFI%TUREORITEM _ <br /> � WATER CLOSET ITOILEn NC—W HNDLG U NITS—H.P. <br /> � FORCEDAIRSVSTEMS—�T.U.� EA <br /> BATHTUB UNI7 HEATERS—B.T.U. M — <br /> 1 _ LAVATOfiY1WA5H BASINI CLOTHES DRYERS -- <br /> , '�� SHOWER VENTILATION FAN <br /> �= KITCHEN SINKB DISP. RANGE HOOD <br /> � , DISHWASHER WqTER MEATER — <br /> LAUNORVTRAV WOODSTOVE <br /> I CLOTHES WASHER — METAI FIREPLACE 8 CHIMNEY — <br /> _— URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN HEAT PUMP <br /> . � FLOORDRAIN GASPIPWG <br /> f BACKFLOW PREVEN'ERS EXHAUST FAN — <br /> �I 1 ' ROOFDRAINS—AAINLEADERS -- <br /> SINK�SERVICE—BAR,ETG) <br /> u � — _ <br /> , '� � SUBTOTAL g � — <br /> SUBTOTAL S — PERMIT S �/ <br /> ' PERMIT S TOTAL FEE S <br /> �t�'� TO7AL FEE S FEE PECEIPf NO. <br /> FPONTSEiOFCK <br /> R[APSEiBACrc SIpE5E19ALN DUNCHECRNUMBEii <br /> vpcnr+r5rte FEES �ALUATION FEE <br /> USEZON[ ��TAAEA ❑VES ❑NO <br /> eui�oiNc <br /> ttPEOFCANST. OCCUPANLVGPOUP NOAFpV.ELIINOlIN1i5 <br /> p��pWABLE/�CTUAL P W MBING — <br /> S12EOFBLOQ NO.OFSTOPIES BSMf. nGGIOAO MECHANICAL — <br /> ❑Y <br /> ❑N <br /> HEIGNiLIMIiAT10N OTHER — <br /> l <br /> . �iRESPRINNLER5RE0UIPE0 ❑YES ❑NO STATEBUILDINGSURCHARGE <br /> STATE ENERGY SURCHARGE — <br /> qPPLICPTIONPCGBY P�AH�APPRBY PUBLICWORKS <br /> TOTAL 7S' <br />