Laserfiche WebLink
AP�LlCAT��?N FOR CONSTRIIC'�ION PERMiY � <br /> TO Bc i.OMPLETED IN BLACK INK—PLEASE ErSINT <br /> BUILDInC DEPARTMENT HEATING SYSTEA4: U GAS U ELECTRIC ❑ <br /> 259-E810 <br /> I_l DEMOLITION 1�COMBINATION I I BUILDING i i MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEFI � IAFILp�DRE55 CIiY 21P PMONE C <br /> �1U1°iLL l7%�U� jg� <br /> �I A ICi�1 GYl L �IS C o� . f�rr 2 5 ��:����„-r i i�z�,Suc�� i�f �.�t n_ <br /> TENANT IdAILApORE ��,Y PMONE •�—�� ���� <br /> �7-� C ��J( O SF- "r-✓�K'h!7' IL7ALLWfFI,��/E�Crr, GUR ' <br /> � 7�y S 1 V�-L �VFnrrr n.5 A[ [ /7r=Gr�F PAh'/� <br /> ARCHITECTOR�ESIGNER MAILApORE55 GTY ZIP PHONF, _ y=t ,'n�C G�R �QU� <br /> � [� � N �^�i� Z�/O �ll� ���� A/� �lU �� 1✓Z�"1 F � O <br /> GENEdALW�RFCtOR ��IA DRE55��� CiiY ZIP ION�E�� ��(15TFTE�COEN($> <br /> ��� /�� a <br /> ��h1ECH�CONTRACTOB MAIL ADDRE55 CITY ZIP PHONE STATE LICENSE A <br /> PLUTAOINGCONTFA�.TOR MAILADORE55 CITY 21P PNONE STATELICENSEx <br /> CONTRACT PRIC.E OF WOBK <br /> I U� <br /> DESCfiIBEWOFK NDSOUA EPO TnGEINVOLVEU GONTFCjPERSONAND�'�1JNEN0. <br /> �-r����'r Pti��2�veM���.�T Kr<�1�1���2c�1� U7o -��l�G� — <br /> �'_�'"L—�,�-�� � ,Sct.r�-� <br /> I HEREBY CERTIFY T71AT I H�VE READ AND EXAMINED THIS <br /> PROPp$EDOSEOFBUILOING /� APPLICATION F.ND KNOW THE SAME TO BE TRUE A'JG :;ORRECT.ALL <br /> �Iv�il..(F�.I/T L PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAlDESCFIPTIONOFaROPERTV�SNOWNBELOWORATT�CHTWOCGPI65� VJORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR � <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK aF ' AUTHORITY TO VIOLATE OR CANCEL THE PRQVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTI'�N OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOP.M THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> anaee�*nz i.o.Nw.�eea CONTRACTOHS LAW 18.27 RCW A�dD 296.2U0 WAC. <br /> CONSTRUCTIONLOPNLENDER.AO�RESS,TEL"cfHONENUM9ER X �/��� •���: � A�/ � �%/�/�� — <br /> /// /n <br /> 'I U XY lK-r <br /> �PROJEC7 AD7R S sic�_uu n.rc� — <br /> 1710 S6� v��'+�ETr N !1 � L 'Rc� r Si�irP �uy n'_ 2-1-.� <br /> arv nusmew uc�ns[uo <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> YJAT[R CLC A/C—A/HNDLG UNITS—H.P. <br /> tlATHTUB _ ,,n/� FORCED AIR SYSiEMS—B.T.L�. M E.A. ; <br /> LAVATORY C' ;y,(J�� /a��-��-� UNITHEATENS—BJ.U. M � <br /> SHOWER CLOTHES DR`fERS —T— <br /> KITCHEN S � /,,, �i CJ VENTILAfION FAN � <br /> DISHWASH \J � — �`��� RANGE HOOD —� <br /> LAUNDRY l WATER HEATER <br /> CLOTHES� �/ J/! ���"�� WOOU STOVE <br /> URINAI METAL FIREPLACE(WOOD BURNING) <br /> URINKING I PIRFPLACE INSERT <br /> FLOOR DPo j��/ .�' � �I%��.'�J,/ HFAT PUMP —'— <br /> BACKFLON � GAS PIPING <br /> ROOF DRA EXHPUST FAN <br /> SINK(SER\ � <br /> � <br /> — � <br /> — � <br /> --� <br /> SUB TOTAL S SUB TOTF� 5 ; <br /> PERMIT c PEFAiIi 5 � <br /> TOTALFEE S TOTALFEE 5 <br /> FQR OFFICc USE �/NLY: _ <br /> FFONTSETBACK REARSETBACK SIDESLiOACK PLAN�ECI(NU/ER FEE �� FEC�T�NO. ��C <br /> / <. <br /> f�% r C �/ <br /> usEzorve �oin�en vncnHisiie FEES VALUATION FEE <br /> i � YES I-1 NO BUILDING -- �0 oou LC� / : <br /> lYPEOFCONSi. NO.CgSTOFIES oi.twm'�,^/ ncarUWuuN;uNnS <br /> � � / ';°np° pWMBING _ <br /> O`- <br /> S2EOFBLOG. FIRESPNRIXlER5RE0'D BnSEMENT MECHANICAL —'— <br /> aa�o TcN,Sv�r� No YES �� No -- --,— <br /> OCCUPAPlCV LOFO FIfiE ALARM RE0�0 MGIGHT UlAITATION AD�ITIONAL PLAN CHECK <br /> 1 1 <br /> �d �� J OTHEF <br /> REASON —�— <br /> / i_ . <br /> • STATE BUILDING SUi7CHARGE <br /> i <br /> RJiAhcE1Y PLPNSAPP WEDBV CITYOFEVERETT PUBLICWORKS <br /> '^ LOCAL SALES <br /> nn, �i - �,- � � TRX CODE IS 3105 TaTA� � ;,S[? <br />