Laserfiche WebLink
�� <br /> APPLICATION �'�OR CONSTRUCT�JN PERMIT ��'<<�« <br /> me e�e�g�een TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITY OF <br /> �n� everett HEHTING SYSTEM: U GAS U ELECTRIC ❑_ <br /> BUILDING DEPARTMENT <br /> C H _� 259-8810 <br /> � �N DEMOLITION COMBINATION BUILDING xMECHANICAL PLUMBING SIGN <br /> ONT5F �aA�LADUFE$$ CITY ➢P PHONE <br /> y N i�„-�w�� ir��;�{�� 222 — ue-�<. ��{ �✓ 9�11�r 3S'j—L�z�/ <br /> �'y� TEYFNT MAILRD�PESS CITY 21P PHONE <br /> 'il y'�U — — <br /> ARCNRECTORDESIGNER �AAILPO�flE55 CITY ZIP PHONE <br /> yhp+x <br /> W O� GENEflALLONTRACTOR M1tAILA�ORE55 CIiY ZIP PHONE LICENSEI <br /> H <br /> OH <br /> � MEGHyNl�f Ly�N�TflFp iOR M LAODRE55 GITY Z'P PHON �LpI ENSEa <br /> �?�5� _��/W W�f'l��f� 3fln f{�c.c �'' �?/f y8'to r �f � �ifi _ <br /> �/Ff ro s KZ <br /> �zHi P:.UMBINGCONTRACTOP M4iLADDHE55 CITY ZIP PMONE LICENSE• <br /> Eyz <br /> H y cisssorwoa� <br /> �jy �i NEW . . ADDITION . .. ALTERATION .. REPAIR �. DEMOUTION . � WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br /> H <br /> n C y CONiNCT PERSCN ANO PHONE N0. <br /> Wr �..w <br /> �iJ GONTqACT PRiCE OF WOPK ��{/�'�rT✓L Cl <br /> �y(� DESCFiBE WOflHAND��UARE FWTAGE INVOLVE� ' <br /> Hofn �p vo <br /> veovoseous�oFew�oine I HEFiEBY CERTIFV THAT I HAVE READ AND EXAMINED TfIIS <br /> APPUCATION AND KNOW TH[SAME TO 3E TRUE AND CORRECL ALL <br /> LEGRLO?SLBiPTIONOFPROPERiY15HOWNBELOWORATTRCHFO�RCOPIE51 PROVISIONSOFIAWSANDORDINANCESGOVERNINGTH15TYPE0F <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEIiEIN OR <br /> ior e�oc« oc NOT. THE GRANTING OF A PER�diT DOES NOT PRESUME TO'� VE <br /> AUTHORITY TO VIOLATE OR CANCEL TNE PROVISIONS OF NY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR ��1E <br /> PERFORMANCE OF CONSTRUCTION.'HAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE- WORK FOR WHICH � <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE . <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATUREOFCONi TOqORAUTlIONREDAGENT DATc <br /> --- —�?����—�- � z� <br /> PROJEC'ADDRESS <br /> RPPII N 'CrtYBlI51NE55LICEN5EN0.A D8t151NE55NAME <br /> ' 1 PLUMBING MEC NICAL . <br /> �! ' NO. TYPE OF FIXTURE OR ITEM FEE NG. TYPE OF EQUIPMENT FEE <br /> � WATEF CLOSET(TOI�ET� A1C—lvHN�LG UNITS—H.P. <br /> '�1 BATHTI:B .� FORCED AIR S`.'STEMS—B.LU. h1 E.A. . <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> ' ' _ SHOWFR _ CLOTHES DRYERS <br /> � KITCHEN SINK 8 DISP VENTILATION FAN <br /> 1 � DISHWASHER RANGE H000 <br /> LAUNDRYTRAY WATERHEATER <br /> ' CLOTHES WASHER INOODSTOJE <br /> URINAL METAL FIREPLACE 6 CHIMNEY <br /> '� DRINNIN:FOCNTAIN FIREPLACE INSERT <br /> �i FLOOR DRAIN HEAT PUMP . <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> ' SINK(SERVICE—BAR,ETC.) '� <br /> � � _— 1 I <br /> � '� SUlTOTAL S SUBTOTAL 5 <br /> `'�I P6:MIT S PERMIT 5 /S I <br /> ... TOD\L FEE $ TOTAL FEE 5 .$6 ' <br /> FOR OFFICE USE ONLY: <br /> iRGNTSETE�CK P[ARSETBACH SIpESETBACN PLANLNECKNUMBEN FE[ P.ELEIPTNO <br /> usezoNe LOTAHEA VAGWT54E FEES VALUATION FEE <br /> BUILDING <br /> 1VCF0lfOpiSPLLOWABiE iYPEOFCONSt.ACiWL amvAxtv naabn'nuucuxns - <br /> 4P00° PLUMBING <br /> SIZG OF BIDG. NO.OF STOPIES PPSEMENT MECNANICAL � <br /> 3e � <br /> OCC�PANCYLOAO FIFlESFRNKLERSREOD NEIGHTLIMIiATION ��D�ITIO'IALPIANCHECK ___ <br /> O�HEP <br /> f1EA50N FOR SPpIKNLERS — <br /> STATG BUILDING SUFCHAIiGE <br /> na�,Keov rinHsnPveoveoev CITYOFEVERETT PUBLICWORKS <br /> � LOCALSALES �— <br /> TAX CODE IS 3105 Torn� �� � <br />