Laserfiche WebLink
_.., - <br /> APPLICwt10N FOR CONSTRI..:TIOM <br /> PERMIT <br /> Ihe Everg�ean everet[ <br /> CITV OF <br /> everett � <br /> BUILDING DEPARTDAENT <br /> 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MNLAD�RE55 LITY ZIP PHONE <br /> ��, /r �3ti �r� � �• �� La�a G��� �a �� �y ���s <br /> T NNNT MAILFD�RE55 CITY ZIP PHONE <br /> AflCMITELTOR0E51GNER MIILRDDRESS CITV 21P PHONE <br /> GENERALGONTPAC�OR MAIl.P�OPESS CITY ZIP PNONE LILENSE� <br /> MECHAII'ALCONTRAGtOR MFILRDDFESS CIiY ZIP PMONE LILENSE♦ <br /> � _�, �� n� " 1��`�� ��:i ('�, ,, � ab Q����j� �- s-� � � <br /> PLOIABINCCONTFACTOP � MAIL.1 CR 55 � ITY ZIP PHO E 1 CGS P /��N�•L <br /> {.� <br /> CLn55OF WORN �//� <br /> ❑ NEW ❑ ADDITION L`7 ALTERATI�N ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> iENANT IMPROVEMENT 0�INTERIOP PEMODEL ONLY CONTACT FERSON AND f'HONE NO <br /> GONTRAGTPRICEOFWOIiK DO O <br /> DESCRIBEWlORNFI:DSUURREFOOTR EINVOLVED <br /> RY I cY'a �'C/S <br /> PflOPOSED USE OF BI111.DING I HEREBY CERTIFY THAT I HAVE READ AN D E%AMIN ED THIS APPLICATION AND <br /> KNOW?HE SAME TO BE TRU E AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> ��h1 �C' ORDINANCF.S GOVERNING THIS NPE OF WORK WILL BE COMPLETEO WITH <br /> LEGALOESCRIPT NCFPROPERlY15HOWN0ELOWORATfACHFOURCOVIES� WHETHERSF�CIFIEDHEREINORMOT.THEGRANTINGOFAPERMITDOESNOT <br /> �,,(� �/�� PRESUME TG GIVE AUTHORIN TO VIULATE OR CANCEL THE PROVISIONS OF <br /> �pi�_ B�ocK.4_J OF �� rU ��� � ANVOTHERS7ATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF GONSTRUCTION.THAT 1 AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERN TO PERFORM TNE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WAC. <br /> SIGNATUFEGFCOMFACTOROFAUtHOR12E�AGENT DATE <br /> 3� �5 Go�-�6a� d X���� `l�- a �- ���5 <br /> PROJECT/DORE55 APPLICANTSGTYBUSINESSLIGEN ENO.ANDBUSWESSNAME <br /> PLUMBING MECHANICAL <br /> Np, • TYPE OF F'IxTU�IE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> IYf�TER CLOSET(TOIL A/C—A/NNDLG UNITS—H.P. <br /> B�YH FORCED AIR SYSTEMS—B.T.U. M EA <br /> J �� RY�WASH BASIN) UNIT HEATERS—B.T.U. M <br /> 5 WER CLOTHESDRYERS — <br /> KITCHEN SINK 8 DISP. _ VENTILATION FAN <br /> DISHWASHER RANC�E HOOD <br /> LAUNOFYTRM' v 'NATERHEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINKING fOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKF:OW PREVENTERS GAS PIPING -- <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN — <br /> SIN K(SERVICE—BAR,ETC.) <br /> SUBTOTAL S SUBTOTAL 5 <br /> PERMIT 3 PERMIT 5 <br /> TOTAL FEE S Tf1TAL FEE 5 <br /> FRONt5ET9NCN REARSETBACR SIpESETBAGN PLANCNECNNUMBEH FEE <br /> PECEIPT NO. <br /> uSEzorvt LOTARER VRCANi51TE FEES VALUATION FEE <br /> ❑ YES ❑ NO <br /> BUILDING <br /> TVPEOFCONST. OGGUPANCYGROUP NO.OFOWELLINGUNItS <br /> qLLOWABLE/O.GtUAI PLUMBING <br /> SIZEOFBLOG. NO.OFSTORIES BSMT. OCGLOAD MECHANICAL <br /> GY - <br /> ❑ N <br /> HEicHruMirnrior+ OTHER <br /> FIRESPRINKI[RSREOUIREO ❑ YES ❑�+O STATE BUILDING SURGHARGE <br /> STHTE ENERGY SUPCHARGE <br /> APPUCATiONFCGBY P�AHSpPPR�Br PUBLICWOFKS <br /> 1/�f1 �II�, TOTAL <br /> � U� <br />