Laserfiche WebLink
' APPLICATIO�. FOR CONSTRUCT►.lN PERMIT �'`'`�`" <br /> ;� � I <br /> m�e�-��n����=� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ciTv or I <br /> everett HEATINGSYSTEM: ❑GAS !7ELECTRIC ;.] —` —� I <br /> BUILDING DEPARTMENT I <br /> 259-8810 <br /> DEMOLITION COMBINATION x BUILDING MECHANICAL 1 PLUMBING SIGN <br /> OWNEP MARRDOP[55 LrtV 2iP PMONE <br /> ke,�t�. C LrJt3�i� 231�1 �t,�ftb'�" f�.��- � 2r2C�1 2�-�ifQ n <br /> �� y iENRNT AIAILA�OfiE55 GILY ZIP PNONE <br /> SI <br /> p � ARCNILECTORDESIGNER MRILRODIIE55 GTY ZIP PHONE <br /> C�NEFRLCP..�HPCTOR MRIIADORESS CIiY 21P PHDNE IICENSE• <br /> �� � ��W �E-�' <br /> IAE!:HRNiCRLCOHiRACTOR 1.1ARA�DRE55 CITV 2iP PMONE LICENSEt <br /> ���I P1111.IBING CONTRRGTOR M�IL AOORESS ��TY ZIP PNONE UGENSE• ' <br /> �7� <br /> CJ� � CLASSOF WORK _ <br /> �9 Fj . NEW : -. ADDITION ��. , ALTERATION . �. REPAIR . DEMOUTION ._- WOODSTOVE/FFPL INSERT ._��. BUIIDING FELOCATION <br /> �� CONTRCTPERSONANpPNONENO. � <br /> G 7�." ps <br /> � CWITFACTPRICE FWOPK c'�✓ O VOU <br /> �M p[SGRiBE:�ORKANO50URREFWTRGEINVOLVED <br /> �y 2��� = 550 <br /> naoro=_�ouseorow�owc � i HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �M 2 � �',���21��� � AFPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � LEGALDESCRIPiIONOFPROPERtt�Sl101YNDELOWOA� HFOUFCOP�ES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> tr �oi X/�Q o�ocK __ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE ' <br /> y [�7 n /� AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> O 60 ( 'i NII)fJ'✓� ('�I-- L fJ + OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE �� <br /> PEflFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE , <br /> �� �'.( ;��� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH i <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE � <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. ! <br /> 2 / �� SiGNFTURE OF CONiRACTOROP AUTHORREO AGENT DRTE 1��Pj I <br /> PRQIEGTApOPE55 —I� � � � � ���N���� <br /> � RPPUC� BUSMESSUCENSENOAN�BUSMESSNAME <br /> .�� �.. pLUMBING MECHANICAL <br /> � NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE I <br /> I ��� WATEF CLOSET(TOILET) fUC—lvHNDLG UNITS—H.P. <br /> � � _ BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M �I <br /> �� SHOV:ER CLOTHES DRYERS <br /> 'i '��I KI7CHEN SINK 8 DISP VENTILATION FAN � <br /> � DISHWASHEF RAN3E HOOD <br /> LAUNDRY TRAY WATER HEATER � <br /> ' CLOTHES WASHER WOOD STOVE <br /> I �_ URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT i <br /> � FLOOR ORAIN HEAT PUMP i ' <br /> � BACKFLOW PR ENTERS GAS PIPING i � <br /> FOOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � � SINK(SE.VICE—BAR,ETC.� I <br /> � <br /> I ���_� ; <br /> , � � SUB TOTAL S SUB TOTAL S ' <br /> PEflM1T $ PERMIT $ i <br /> ' '_� TOTAL FEE $ TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FPDNiSEi�ACK AEAqSETBr1CK SIDESET04C� PI/A�NCMECNNUMOER FEE RECEIPTNO <br /> � � 5 7� r 7"`�J 7 ��. o?G / 7� <br /> usezoHe I' �ornaerya � VACANTSITE FEES JVALUATION FEE <br /> �"{ �fUAI �' BUILDING y, �O� Q� ; �" <br /> I�PFOlCON(S.ALIOWABIE 1YPEOiCON51AGIUAI acuv�gcv noa�onuueconuz i <br /> eaouv PLUA181NG <br /> ---��� —J <br /> Sb'E OP BLDG. NO.OF STOFIES BASEMENT MECHANICAL <br /> 70 5 I Nu � <br /> OCGUPANCYLORO FIRESPRNNIERSREO'D HEiGHTLIR11TAiiON ADDITIONALPLANCHECK i <br /> N N� I S� � <br /> OTHER � <br /> P[ASON FOR SPHINNLEflS 1 <br /> STATE BUILDING SURCHARGE �j(� <br /> i41ANE0Y PLRNSr1PP OVEOOY CITY OF EVERETT PUBLIC WORKS '(� � � <br /> nl LOCALSALES �3 � s v�' <br /> F� g � TAX CODE IS 3105 rorA� n va� � • <br />