Laserfiche WebLink
Iha Evorgreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />''I'�".�'" /-+�+tcP-� <br />APPLICi�.tION FOR CONSTRI.a:T�Kr�I <br />PERMIT �y��,Q,,,;l <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />��, ZO <br />Z� �. 2.0 <br />� <br />�7?(a tJr— de�nJ�C1'✓sce _�,��%ZcHt�s�i <br />pqLHli�CiOR ESIGNEfI MAIL�DORE55 IIY ZIP PIIpNE <br />0 <br />-- C�. L r_ / Fa� � / <br />NEW ❑ AUDITION ❑ ALTERATION ❑ R PAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPL INSERi ❑ DUILDING REL(iCATION <br />tENnNiIAtPROVEMENtORIMER10RREMOO,E�L_�ON�LY/ CONi�CIPE SONAj��\QQQ...�[[[iM/D NENO �,/ //� <br />LONiR4CiP(iICEOFWOfiK �� S�J(f C':,������"� �. �//�C%yGf� .��� <br />OE��9EWOPN�DSOUMEfOOi�GEINVOWE� '/O�/ � ��``/ � <br />_ . / I � T f09 <br />0 <br />LGT,�� BIOCK OF <br />JJCYi VI�CJ <br />�� � <br />PLUMBING <br />TYPE OF FIXTUfiE OR <br />WATER CLOSET (TOILET) <br />BA7HTUB <br />LAVA70RV (WASH BASIN) <br />SHOWER <br />KITCHEN SINKB OISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DPAIN <br />BACKFIOW PAEVENTERS <br />ROOF DRP;NS- RAINLEADERS <br />SIPiK (SERVICE - BAFi. ETC.1 <br />PERMIT S <br />TOTAL FEE $ <br />FRONISEIBACK qFJ�quE1BRClt SIOtSEiUA <br />2o Zo LS <br />US[20 LOIAREA \rl ANiSrtI <br />� �ES Ll <br />1YPEOfCONSi. p�CU ANCVOROUP ND.OFDWE <br />PILOWAOIE/AGTUAI <br />v yN �= �- 3 f <br />srzeorotoa. HooFstomes eSMc oc0.�ono <br />�/p� �1 ti `�'Y -- <br />N <br />N Rr �fe Sp� IIEIGNTLIM <br />FIRESPRINKIERSRE0UIf1E� ❑YES IqMO <br />pPPLICR110NACC.OV PLFNSAPPB.DY <br />� � �� <br />1 HEREBV CERTIFY TI1AT I HN/E READ AND EXAMINED THIS APPLICA710N ANO <br />KNOW THE SAIAE 70 BE TAUE AND CORRECT. ALL PROVISIONS OF LA\YS ANO <br />Of1DINANCES GOVEfiNING TFIIS TVPE OF WORK WILL BE CGMPLETED WITH <br />W HETHCR SPECIFlED HEBEIN OR NOT. THE GP.ANTING OF A PERMI i DOES NOT <br />PRESUME TO GIVE AUTIIORITY TO VIOLA7E OR CANCEL THE PROVISIONS OF <br />ANY OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br />F09MANCE OF CONSiRUCTION. THAT I AM AUTHOf71ZED BY THL OYJNEti OF <br />7HI� PfiOPERT\' 70 PERFORM THE WORK FOR WHICH APPLICA710N IS M�DE <br />P�ND I COMPLY WITH THE STA7E CONTRACTORS LAW 1827 RCW AND <br />2P6.:00 WAC. <br />Sic��aunroc'cor+tnnttonannUmonizeonceNr onre <br />X <br />APPUG�NLS CII V � W INESS I IC[�ISE NO. �ND OUSW ESS NAIA[ <br />MECHANICAL <br />NO. TYPE OF EOUIPN <br />A/C — A/Hf�DLG UNITS — H.P. <br />FORC'c0 AIR SYSTEMS— B.T.I <br />UNIT HEATERS— B.i.U. M <br />' CLOTIIFS DRVERS <br />7 VENTILATION FAN <br />HEATER <br />EXI{�UST ('AN <br />FEE <br />M EA <br />SUBTOTAL _ S }� <br />PERMIT g <br />TOTAL FEE $ r <br />FEE f1ECE1PTN0. <br />z.s�Z, s� i 33� � <br />euaoiNc <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHqpGE <br />Pueuc wonKs <br />Tora� <br />C <br />.� <br />