Laserfiche WebLink
------ - ------ ---- ---- -- ----- <br />. .._._.. �:. <br />: �. <br />APPLICATI4�] FOR CONSTRUCTL�JN PERMIT `� <br />TO BE COMPLETED IN BLACK INK-PLEP.�E PRINT � �� <br />:. <br />HEATING SYSTEM: GAS ❑ ELECTRIC ❑ � �`. <br />tUILDING DEPARTMENT �' <br />59•8810 <br />I DEMOLITION I:I COMBINATION I I BUILDING �q�IECHANICAL CI PLUMBING ❑ SIGN <br />i <br />i <br />��Nf.f1ALCONLMCiOf1 M�IlA0DFlE55 CI7V ZIP PIIONE STATELICENSE� <br />�ECN�NICALCONTRACTOR MAI ODflESS CITY 21P HONE 5T ELICENSEI � <br />�o��-�-�� co ,,(,�15 z�-sw Lyul�wcuD qSo3�5 6�-Iq,� �LaDF�s�cl"�K� ; <br />I.UM�INGGONiR�CTOR AllAODRESS CITV ZIP � PHONE ✓STATELICENSE� <br />r. <br />LqSSOF WORN � <br />�NEW I 1 ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I..I BUILDING RELOCATION <br />� ` CONTACT PERSON AND PHONE N0. '{ ,1� ��}��A �` <br />oNTFACT PRICE OF WORK ��� Z J� O •� I ' M..J `�"�'l.s� /7TR � j <br />�FSCQIBE WORK �HD SOUAflE FQ'IiAGE INVO�VEU .' <br />�I �, G%5 l►JF - �" i'1�II�C> Q- S � <br />'IOPOSE0U5EOF0UILDING i HEREBY CERTIFY THAT 1 HAVE FEAD AND EXAMINED�THIS '� <br />�1 j� � �� �Q� APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL ;'�I <br />F.GALDE�NOFPROPEflTV�SHOWNBELOWORATTACHFOUBCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF ;'I <br />WORK WILL B[ COMPLETED WITH WHETHER SPECIFIED HEREIN OR :' <br />or BLOCK oF NOT. THE GRAtlTING OF A PERMIT DOES NOT PRE51)ME TO GIVE <br />AUTHORITY TU VIOLATE OR CANCEL THE PROVISIONS OF ANY , i <br />0'fHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT S L 18. 7 RCW AND 296200 WAC. <br />X <br />` �oz3°11 <br />s�cr+nrune o e <br />PLUMBING <br />O. TYPE OF FIXTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUPlDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ETC <br />�OR OFFICE USE ONLY: <br />�AONt5ET0ALN REAflSET�ACK <br />ISE ZONE <br />iyPE OF CONIS. AiL01 <br />�IZ[ OF OIOG. <br />UCCUPANCYIOAD <br />9EASON FOR SPRII <br />4l7AN@ BV <br />FEE <br />PERMIT $ <br />TOTALFEE $ <br />IYPE OF CONSC ACIURL <br />NO.OF STORIES <br />FIfiE SPRNKLERS REO'D <br />4N5 APPROVED BY <br />� <br />VACANT SITE <br />N0. � TYPE OF E�UIPMENT <br />A/C—A/HNU�G UPJITS--H.P. <br />UNIT HEATERS—B.T.U. <br />CI.UTHES DRYEr'.S <br />`/ENTILATION FAN <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPUICE & CHIMNEY <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUST FAN <br />BUILDINO <br />occuruxr rmaownuxauxns <br />�n�" ' pLUMBING <br />eASEMENT MECHANICAL <br />HEIGHi LIMITATION AD�ITIONAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WOFiNS <br />LOCAL SALES <br />TAl( CODE IS 3105 TOTAL <br />M E.A. <br />SUB TOTAL $ ' — <br />PERMIT $ � — <br />TOTALFEE $ '"' <br />RECEIPT NO. <br />