Laserfiche WebLink
rhe fverR•een <br />��,�oF <br />everett <br />�ITY MALL 259�8745 <br />�� .-�ONSTRUC710��� <br />PER11iIIT� PeR�nir wo. 16400 <br />EVER[T7,WA98201 ❑ COMBINATION G� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEN MAILADDRc55 CITY ZIP PHONE <br />NAPA AVPO P*RTR 60i GT' �VFRFTT hiATT i9TV S'VFRT'T�` LdA QR�n4 �5�-71d1 <br />ARCHITECT p!i OESIGNER MAIL A�OflE55 CITY 21P PMONE <br />GENEPAL CONTRACTOR MAIL AODRE55 QTY ZIP PMONE UCENSE Y <br />T[1SE AAT SIGNS P n Ar�x 9019 m�FRnTT W' QR9llf, ➢S9-f1f1RF TnRnacTlFlRe.� <br />MECNANICAL GONTRACTOR MAIL AD�RESS CITY 21P PM011E LICEkS[ N <br />PLUM�ING CONTR�CiOR MAIL ADDRE55 CITV ZIP P40NE LICENSE M <br />❑ NEW C� AD01TI011 O ALTERATION ❑ RE�AIR O DEMOLI710N ❑ FENCE �_ SIGN � 1 \VOOD STOVE/FIREP;.ACE INSERT <br />VFLUATION OF WOflK <br />= 5400.00 - <br />GESCfl16E WORK <br />OF <br />LOT__BLOCK_OF <br />PLUMBING <br />NO. TYPE OF FIXTUHE OR <br />WATER CLOSE7 (TOILFn <br />OATHTUB <br />LAVA70RY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WA7ER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DFAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAI <br />PERMIT <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S.GRADING _ <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTA7EMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />MPS <br />FOUR <br />I HEREBY CERTIFY THO.T I HAVE READ ANQ EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. N!_L PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNINC= iHIS TYP[ OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIULATE <br />OR CAN::EL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />Ef�ASOFEOFCONTflACTORORAUTHORI2E�AGENT _ 1 �ATE/ _ <br />FEE N0. TYPE OF E��1IPMENT <br />AIR COND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. UNI7S - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />bVALL HEATERS - B.7.0 M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLO7HES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIi - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />S <br />5 <br />REAR VARD S <br />VACANT SITE <br />i!YES ❑NO <br />NO. OF DWEL <br />MA%. OGQ L( <br />FIAE SPRINKI <br />REOUIRED <br />GYES GNO <br />BY <br />PLANS CHECKED BY APPR.FORISSUANCE BY <br />ELEC. - NV <br />LC - 4/14/86 <br />ret <br />SUBTOTAL 5 <br />PEHMI7 S <br />70TAL FEE S <br />! NUMBER PLAN CHECK FEE <br />FE[ I f?ECEIPT NO. <br />FEES V�ILUATION FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />$ s400.o0 � Zil o0 <br />TUTAL I I 21� 00 <br />PEHMIT VALIDATION <br />WHEN 'ROPERLY VALIDATED (IN THI� � iC�) THIS,LS�ptlfj PF�i�IT_ C♦ <br />'� L I U ti <br />�i <br />L�:� <br />.. �. .... �..� �-. I.�'�j c'-' <br />SIGN AT,L ON PRSVATE PROPERIY.� "'!„ ', 'I <br />NDDRESS fILE <br />� ) <br />�Ji� cU <br />