Laserfiche WebLink
APPLIC:aT10N FOR CONSTRuCT10N <br /> PERMIT <br /> Ns Ewrpreen eveiel[ <br /> CITY OF <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•BBtO TO BE COMPLETED IN INK- PLEASE PRINT <br /> CWNER MRIL�DDPE55 CITY ZIP /� MIONE <br /> ���� �� �� �DDR��� � �T� � �� ' Z' IP " PMONE � � <br /> ��, (1�1.0 <br /> AfiCNREGT dE9 ER MNtADORE55 CITY 21P PHONE <br /> OENERALGONTflAGTOR MAIIA�ORE55 CITY 21P PMONE LICENSE• <br /> MECHANICA,CONTN�CTOR M�IL�DOPESS GITY 2iP PMONE LICENSE• <br /> PLUM&NOCONTR�GTOR MAIL�DDRE55 GITY 21P PIIONE IICENSE• <br /> CLA44OFNORN <br /> ❑ NEW ❑ ADDITION ALTEFATION ❑ REPAIH ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUIl01NGRELOCATION <br /> IEN/JITIMPROVEMENTOHINTERI REMODELONIY CONUCTPEPSONANDPMONENO. <br /> CONTMCT PPICE OF WONK <br /> pEBLPolE NpRK NIO 50 WflE fO0T�0E INVOIVED <br /> Eo EorOu allo IHEREBYCERTIFYTHA7IHAVEREADANDE%AMINEDTNISAPPLICATIONAND <br /> ' KNOW THE SAME TO BE TRUE AND CORFECT.ALL PROVISIONS OF LAWS AND <br /> lEOw Ri Ti NOFPpOPERtt�SHOWNBELOWOR�TT�CNFOIIRLOPIES� ORDINANCESGOVERNINGTHIS7YPEOFWORKWILLBECOMPLETEOWITH <br /> WHETHERSPECIFIEDNEREINORNOT.THE aRANTINGOFAPERMITDOE9NOT <br /> � PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> LO7 e�xK oF ANYOTHERSiATEORLOCALLAWRECULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE OWNER OF <br /> THIS f'ROPERTY TO PERFORM TME WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WNC. <br /> SIGN�TUB[OFCONiR�pONOR.1U1110R12E0�GENi OATE <br /> X <br /> PIIOJECi AODRES4 IpVLIGANIS CIiY BUSINESS lIC[NSE NO ANP BUSINE55 NAME <br /> PLUMBINO MECHANICAL <br /> NO. TYPEOFFIXTUREORIYEM FEE NO. TYPEOFE�UIPMENT FEE <br /> WATER CIOSET(TOILET) A/C—NHNDLG UNITS—H.P. <br /> g�7�{7�Jg FORCED AIR SYSTEMS—9T.U. M EA <br /> UVATORY(WASHBASIN) UNITNEATERS-9T.U. M <br /> 9MOWER CLOTliES DRYEFS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY Wl.TER HEATER <br /> CLOTHES WASHER WO00 STOVE <br /> 'URINAL METALFIREPLACEBCHIMNEY � <br /> DRINKING FOUNTAIN FIHEPLACEINSERT <br /> i FLOORDRAIN HEATPUMP <br /> I BACKFLOW PREVENTERS GAS PIPING <br /> � ROOFDi7AINS—RAINLEA�ERS E%HAUSTFAN <br /> SINK(SERVICE—BAR,ETG) <br /> � <br /> f — <br /> I SUBTOTAL S SUBTOTAL S <br /> + PERMIT S PERMIT S <br /> � TOTAL FEE S TOTAL FEE S <br /> FHONTSEfB�GN REAPSETBACK SIDESETBACN FIANCNECNNIIMBEP FEE RECEIPTNO. <br /> usexoNe lOrenEe WGNTSITE FEES VALUATION FEE <br /> ❑YE9 U NO <br /> TYPEOFCAN57. OGGUP�NCYOPOUP NO.OFOWELLINOUNITS BUILDING <br /> ���pWABLE/AGTUAL PLUMBING <br /> 52EOfBlOO. NOAFSTOfl1E5 0.51Ai. OCGLOAD <br /> ❑v MECHANICAL <br /> ON - <br /> HE�(i11TLIMIT�TION OTHER <br /> iIHE SPRINNLERSPEWIFED O YES ❑NO � STATE BUILDING SU(iCHARGE <br /> STATEENERGYSURCHARGE <br /> APPIIC�TION�LG BY PL�N9 APPR 0Y <br /> PUBLIC WORI(S <br /> TOTAL <br />