Laserfiche WebLink
14PPLIC�►TION F�R CONSTR�ICTION <br /> P�RMIT <br /> the Evergreen <br /> CITY OF <br /> evere[1 <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> �OW � MAILPDOPE.iS GITY Zlp PHONE <br /> � e� � (�o� �ve�e� 5y�-�9�� <br /> N NT MAILADDRESi CITY r iiP PHONE <br /> AlIGNIiFCfORDE5IGNEP MqIIAD�PE55 CiTV ZIP PHONE <br /> GENEiVALCONTP�CTOfl MAILAODFE55 CITV ZIP PHON� LICENSE+ <br /> u duYt.�y/1 <br /> MECNANICALGONTRAGiGN MRILPDORE55 CIiY ZIP PMONE �ICENSE• <br /> PLUM2INGCONiqAGTOB MAILADDFE55 CITY 21P PHONE LICENSE� <br /> f,LRSS GF WORY. <br /> L NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR (] DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUIL�ING RE�OCATION <br /> 'ENANT IMPROVEMENT OR INiEqION REIAOOCL ONLY CONTACT PERSON FND PNONE NO. <br /> CONTRACtPRICEOi WORk �� q n Q� <br /> O <br /> DESCPiBE WOPK PNO SOUAPE FOOtAGE iNVOLVED <br /> PROPOSEDUSEOfBW DiNG IHEREBVCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONANO <br /> X �' . <br /> KNOW?H E SAME TO BE TRUE AND CORRECT.ALL PHOVISIONS OF LAWS AN D <br /> �cG �oesc PTION PPOPERTV� IIOWNBELOWORATfACHiOURGOPIES� ORDINANCESGOVFRNING7HISNPEOFN'OHKWILLBECOMPLETEDWI�H <br /> IC �f� 2dG WHETHER SPECIFIED HEFEIN OR NOT.THE GRANTI NG OF A PERMIT�OES NOT <br /> X �o7�Z'� etoCK�° oF ��.P/P /�/1/ L PRESUME TO GIVF AUTHORINTO VIOLA7E GR CANCEL THE PROVISIONS OF <br /> — ANYOTHEPSTATEORLOCALLAWREGULATINGCONSTRUCTIONOR7HEPEfi� <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPEF7V TO PERFORM THE WORK FOF WHICH APPLICATION IS MADE <br /> — AND I COMPLY WITH THE SiATE CONTRACTORS LAW 18.27 RCW AND <br /> 296200 WAC. <br /> SIGNATUflEOFLONLRACTORORAUTMOPi2�D�T OAiE <br /> / � <br /> X �'"✓' ��/(�/ /o/�� <br /> PPOJ:CTRO�R[55 qPPLi NSCRv SMESSLiEEN.,E OAN�BUSMES R6iE <br /> � l 7 2� e ��/e�e <br /> PLUMBINfi MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) !VC—A/HNOLG UNITS—H.P. <br /> BATH7UB FORCED AIR SYSTEMS—&7.U. M EA <br /> LAVA70RY�WASHBASIN) UNITHGA7ERS—BT.U. M <br /> SHOWER 5 �j'�_ CLOTHESDRYERS <br /> KITCHEN SI4K8 DISP. VENTILA710N FAN <br /> DISHWASHER RANGE kiO�D <br /> LAUNDRVTRAV WA7ER HEATEA <br /> CLOTHES WASHER WOOD S70VE <br /> _ URINAL METALFIREPLACEBCHIMNEV <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACNFLOW PREVENTERS GAS PIPIN� <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERVICE—BAR,E7Q) <br /> _ _ SUBTOTAL g � U SU�70TAL 5 <br /> _ PERMIT $ pERMIT 8 <br /> TOTAL FEE g TO7AL FEE S <br /> FRONiSEibAGK qERBSRAAGH SIpESEiDACH PUNCHFCNNIlMO[II FEE flECEIPTNO. <br /> ?� � Zm � S'��-f�� ° YD°r J <br /> usezo�F� ^ iornaea vnCattsim � � FLES VALUATION FEE <br /> j/�A C YES O NO <br /> f � �iVPEOFCONST. OGCUPANCYGROU NO.OFDW[LLMOUNITS BUILCING <br /> ALLOWABLE/AGiUALj/ � � � ' <br /> _j � PLU6161NG <br /> SIZE OF p�pC.. NO OF STOBIES USIrt. OCG LOAD � <br /> i/� lG��� n� _ MECHANICAL _ _ <br /> �O d/ <br /> ��eim+tuurtnnorv OTHEFi <br /> �� --_ <br /> FInE aPRINNLERSPEUl1IRE'� ❑vEs i o STATE BUILDING SURCHARGE C., <br /> S7A7E ENERGY SURCHARGE <br /> FPPLIGTION RCG.BY PLANS APP Y - <br /> PUBLIC WORKS <br /> �U� I 70TAL ` n C- <br />