Laserfiche WebLink
APPLOC�►TION FOR CAIdSTi�l..�'fi��4 <br /> PERMIT <br /> the Evergreen tt <br /> CiTY OF <br /> everett � <br /> 6UILDING DEPAFTIvtENT <br /> 25s-BeiO TO BE COMPLETED IN ItJK— PLEASE PRINT <br /> _::NER IAPILAODHL55 GIiY tIV 4'n(J'.� <br /> �'���� /,�-1� 3���rt'ac?�/? Fv�a�7/ zs�-3�� <br /> o� �� <br /> r.ini�Rooa�ss nrr ziv ononc <br /> � i �� � � � � �� � � . . <br /> � r c:.r ziv vHa�e -- <br /> :.:t�Mrtf�ORCES�GNER MnILADDRE55 r y� >y <br /> 1-3(']1"'� C�EnIER➢LC�A 1� ��V ���DPESS II� ZJ �S /a��-�ySt C��.rtC// �HJ/'�7�LILENSE• <br /> sr7 <br /> E � � � � � r � ' SNo,Yr��S'���fi'/i� <br /> ��� 1:[L ANiCALCONiRPLTO ' MAILFODRC55 CIiY 21P PNONE — uCCNSE• <br /> r�y[/� � � ` 1 .— __" - <br /> H ,+3 GLUMBWGGONTRACLOP IAIIL�ODRE55 LrtY ' ZIV — PHONE— liCEt+SC� <br /> � � J <br /> H z r+ i � \ � _ . <br /> K �� cussor..�:.. 1 <br /> O CT7O ❑ NEW �DITION ❑ FL7ERATION ❑ AEPAIR ❑ DE410LITION ❑ M/00DSTOV✓FRPLINSERT ❑ BUILOINGFELOCATION _ <br /> y �� iExANTiMPPOVEMENTORiMEPiOAAEMO�ELONIY CANiACTPEN50NANDPNONENO <br /> H r CONiRACiPNiCEOFWORK�1 .�N /�//�X ��D�S��� ���-/ ��� ..-.. <br /> � O� OESCPIBEWOReANp$OUAPEf00 GEINVJWED '�� � / �'7� <br /> J <br /> � c� 7" ,v Yn t']-.cTir� D�...i/��'�ry 1Z_�.f--7 _.—__ — <br /> rnov STE6LseOPew�mHG T J � IHEFEBYCERTIFYTHATIHAVEREADAN�EXAMWEDTHISAPPUCATIOVAND <br /> H C+7� KNOW'.HESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAVr'SFND <br /> �" n �aMi��/ n/�C�=��� b ORDINANCLS GOVERNING THIS TYPE OF VlO�K WILL BE COh1PLETED`NITH <br /> ~' L[CJI.OESCHIP[QNOFFHpPERTYl5 W IOWOPATTALN�OUFCOPIE51 WNETHERSPEGFIEDHEREINORNOTTHEGRANTINGOFAPERldITDOFSk01 <br /> "L H <br /> �s/` �� PRESU�dETOGIVEAUiHORINTOVIOLATEOiiCANCELTHEPROVISION$OP <br /> 9 y z tGT� B�OC�� or ANYOTHERSTATEORLOCALL4WREGULATINGCONSTF�CTIONORTHEPER� <br /> �..�y FOR!dANCE OF CONSTRUCTION.THAT I AM AUTHOFILFD BV THE OWNER OF <br /> � (/� ^ TMIS PROPERTV TO PERFORM THE WORK FOR lNH ICH AFPLICtiTION IS A1ADE <br /> H ASSG='�^DI� P�¢ p qT Twr1jLLQr>/ AND I COMPL� WITH TME STATE CONTRACTOAS Lu.'J 1i?2i C.CK' APlD <br /> O Cy V7 � -�--� 296200 PAC. <br /> � �r a37S'��� � �� —. qG"IAiL'r,[0[CO'lIPACtORpiliUiMOR4EDAGENT � ��. <br /> Cl c� x rAe�.d.,.�b� . . <br /> z H Co <br /> y o�' f�'��M:sd1'a��lTv1��/L�y13'�11'vcd[zz,�,� <br /> PPOJCCt4C�IlFlS� � nPPUUrybU1VCVS�NGSStiCL�S[NOPN�f1U5�NES5NAME . <br /> ,��,2�3 I OI�?��2 — <br /> PLUMBING MECHANICAI � <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOII.ETI __ _ A/C-N�!NDLGUNITS-HP. _ __ <br /> �� BATHTUB __'__ __'__ __ ____ _ " ___- FOiiCEDAIRSY5TEM5-BT.U. MEA ___ _ ._ .. <br /> I ' LAVATOflVI�'�'�HBASINI UNITHEATERS-B.TU. M <br /> v v, __ <br /> SMOWER CLOTHESDRVERS _ _ <br /> KITCHEN SINKB DISP. VENTILATION PAN _ __._ <br /> ��' � DISITYlASHER RANGEHO00 _ _ _ ___ <br /> � I - - — WATER HEATER <br /> "-�+�.i LAUNDRY TRAY — <br /> CLOTMESWASHER WOODSTOVE _ __ <br /> � URINAL _ METAL FIREPLACE 8 CHIMNEY _ _ <br /> I �' DRINNINGFOUNTAIN __ P�REPLACEINSERT <br /> .p�— FLOOR OFAIN __ 'IEAT PUMP <br /> BACKFLOW PREVENTERS __ GAS PIPING _ <br /> 6^" - ROOF DRAINS-RAINLEADERS _ _ E%NAUST FAN _. <br /> �! SINK�SERVICE-BNR.ETC) - <br /> (.. ,. �+ _ __- . <br /> „� <br /> SUBTOTAL S SUBTOTnL S _ <br /> 'R � 0 PERMIT 5 PERMIT 5 _ _'__ <br /> .w� - _'__ _ _ -___ _' <br /> TOTALFEE 5 TOTALFEE _� <br /> lPONi5t1ItRCN ��CARSEiBACtt S��CSL�f3ALM PUNCNC MNUMBEP FCE �� NECEIVTNO. <br /> . �- � • � ���o � -, 1 �-�-�:�� ;� �=�- ������ <br /> ,�;�:��� ioren[a wcnNisiii %- - I FEES VALUATION---- fEE <br /> � ���y� L res ✓r+o /� <br /> .��'��� BUIL�ING tJ <br /> i �/ <br /> 1rr;G�CONSi OCCpP�NCVGFOUP NOOfOWELLING11N115 ___ ��j ��-O-�aV —i `? -.�� <br /> ���.�,r;�::.u�Ei�GrUai PLUh7�ING <br /> _-5�11—_ �'--3 ( — -- - --- — <br /> .; I;r�ioc ��oF sioa�i s es�.0 occ�oao <br /> - y MECHANICAL <br /> /Z4N sF 2 �;H N�_ — ,� `� � — � - ,—c; <br /> -- ��[icHturnrtnuor+ OTHEP , �_�' <br /> n�� ili_L <br /> na�•.rn_ve�er,sne�imaeo ❑res Ho _ ���J __ STATE BU�LDING SUFCHARGE �I � <br /> STATEENERGYSURCHARGE <br /> <�+�i iCqi1QN�1CC 8Y �/J PLANSAPPP BY � � pU�LIC WORKS �7 <br /> ""�� 111� TOTAL �� /. ��� <br /> � <br /> � <br />