Laserfiche WebLink
lhe �verKreen <br />� p7Y OP <br />everett <br />259-8745 <br />"� C�''NSTRUCTION <br />PERMIT <br />� <br />� <br />PERMI f NO. G O� U� <br />❑ DEMOLITION ❑ COMBINATION �;BUILDING ❑ MECHANICAL '� PLUMBING ❑ SIGN <br />OWNER MAILADDRESS ❑TY 21P PHONE <br />Carol Ann Hagglund 3009 Leonard Drive �erett 98201 259-3069 <br />FRCNITELTOf OES�GN[F MRILRDORESS CITV 21P PHONE <br />GENERALCONTPnLTOR Mnll/DORE55 CrtV ZIP W�ONE L�CENSE� <br />Owner <br />MECMPNILALCOM(IACTOR MAILADpRE55 CITY ZIP PHOLL LICENSE• <br />GWMpINGCONTR/GTOF MRILAD�RE55 CRY ZIP PHONE LICENSE� <br />❑ NEW ❑ ADDITION <br />5 4,200.00 <br />ALTERATION ❑ HEPAIR ❑ OEMOLITION ❑ BUILDING RELOCATION <br />Restructure xoof - Chanye from flat to qable <br />NEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOOOSTOVE ❑ OTHER <br />LOT _ BtOCK _ OI <br />PLUMBING <br />NT- <br />WATER CLOSET (tpILE77 <br />BATHTUB <br />LAVATOFY (WASH BASIN� <br />SHOWER <br />RITCHEN SINK d �IvP. <br />DISHWASHFR <br />LAUNDRY TfiAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DPAINS — RAINLEAOE <br />SINK �SEHVICE — 9AR. ETC.� <br />OR <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />fPONTSETBACR f1E4RS[TOACN <br />ZQ� 2�� <br />1I5E20NE LOTAREA <br />R-2 <br />1�PEOFCONST OCCJVANCYGRi <br />V-N R-3 <br />SIZE Oi �IDG NO OF STOFIES <br />182 Sq ft 1 <br />FIRE SPRINKLEAS REOUIREO ❑ YES D � <br />APPLICAiIONACC [tY PtANSCH[CNEC <br />641 <br />� <br />on <br />I HEREBY CEFlTIFY THAT I HAVE READ AND EXAM�NED THIS <br />APPLIC4TION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVIS�OtJS OF LAWS AND ORDINANCES <br />GQVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR �lOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />3TATFjQR LOCAL LAW REGUL,ATING CON�7RUCTION OR <br />XGN�'Tl E Of CONT �. ALII <br />i`(,� � :,,,, <br />MECHANICAL <br />oa oivrvcn / oa*e <br />t,�: Lti-z � -/ S� ll <br />FEE NO. TYPE OF EOUIPMI:NT <br />A�C — F'HNDLG UNITS — H P <br />REFRIGERATION UNITS — H P EA. <br />BOILEPS — BT U iH.P. <br />GAS FIRED � C UNITS — BSL <br />FORCEDAIRSYSTEMS-3T.U. MEA. <br />WALLHEATERS—BT.0 M <br />UNIT HEATEFS — B T U. M <br />EVAPORATIVE COOLERS <br />CLOTMESDRVERS <br />VENTILATION FAN <br />RANGFHOOC <br />WATERHEAT[R � <br />WOGDSTOVE <br />MEiAL FiqEPL�CE L CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIFING <br />E%HAUSTFAN <br />�4�N PLAN CMECK NUMOER <br />5' BB�ZOZJrJ <br />sire FEES <br />❑ NO <br />WELIINGlIN1i5 �UILDING <br />1 PLUM6ING <br />F1V I APPR 10li <br />� <br />A <br />MECHANICAL <br />FEE <br />SUB TOTAL <br />PE T <br />TOTAL FEE <br />F NUOOOZOSS AECEIPT NO. <br />�265 10604 <br />A710N FEE <br />INVES7IGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCNARGE <br />DRIVEWAY PERMIT <br />Sec.304(c� <br />TOTAL I I <br />PERMIT VALIOATION <br />WHEN PROPERLV VA�IDATED (IN THIS SPACE� iNI51S YOUP FERMIT <br />:..'C�iL55 i I'_E <br />�� <br />LO <br />N <br />O <br />N <br />1 <br />