Laserfiche WebLink
.. .. .�_._i:_7_.... ..—'—... ._�_ .... .. . ' -' -----`-- - ' H.. <br /> I'�f..,+ �;; <br /> APPLICATI�IV FOR CONSTRUC��N PERMIT <br /> everett <br /> �e Evergreen � i�. <br /> I7V OF <br /> everett �' <br /> �UILDING DEPARTME��T <br /> '59-8810 TO BE COMPLETED IN INK—PLEASE PRINT �•. <br /> � DEMOLITION (� COMBINATION I_I BUILDING �MECHANICAL ❑PLUMBING ❑ SIGN y` <br /> �ivNER �,�j�IL JD���''1 ��1 l.U.�L/V ��� 4l.11`a/13 I��JV ~E�7� O � �. <br /> ` I I' l� i. <br /> VtiTJ <br /> r J 7 MNLADDRESS CIIY ZIP PHONE <br /> i <br /> ICHITEGTONDE5IGNER MAILFOORE55 ��TY =�P P���E <br /> f_� � <br /> . '-ENE . TRACTOP MAILADDRESS CIT I PMON[�-� LICENSE� <br /> VALLEY NATURAL GAS, INC. �(�I�t�j��3 x , <br /> `EGHIINICALCONTRACTOR FE �dl'����T� Z�P FHONE LICENSEI ' <br /> a 2605 McDougall <br /> 'I.UMAINGCONTNACTOR 4( 04 mgon CITY ZIP PHONE UCENSEI ' <br /> k - �. <br /> i '�!ASS OF WORK - <br /> I NEW ❑ ADDITION _ tTERATION LI REPAIR I J DEMOLITION I�_I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> ' �FNANTIMPHOVEMENTONINTEfiI RflE ODEIOfJL: � ` CONTACTPERSONANDPHONENO. <br /> � ;ONTR�CTPPICEOFWOBK: L S � • <br /> ? n[SCFI9EWCRKAND UAPEF TA �NVOWED ,�� � ' <br /> y C n i�.�-�r_ <br /> `s <br /> VROPOSEOUSEOFBUILDINO '^ I HEREBY CERTIPY 7HAT I HAVE READ AND EXAMINED THIS <br /> '� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL . <br /> �CQAI DESCFIPTION OF PROPEHTV(SNOWN�ELOW U��TTACH FOIIR COPICS� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OP <br /> j WORK WILL BE COMPLETED WITH WHETHEH SPECIPIED HEREIN OR ��, <br /> i �.oT BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> j AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ; <br /> ! OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE . <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLICA710N IS MADE AND I COMPLV WITH THE STATE <br /> � CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNANREOFCONTMCT PORAUTNORIZEDAGENT DATE <br /> I — <br /> ' - X �m� <br /> � rAaecTwor+�ss � � / _�i <br /> { �C�� APPLIGRNTS CITV BU INE55 LICENSE NO.AND BUSINE55 NAME <br /> \ <br /> i PLUMBINO MECHANICAL <br /> � NO. TYPE OF FIXTURE OR REM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—H.P. � � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T . E.A. ' <br /> i LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHESDRYERS ' ' <br /> � KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> � DISHWASIiER � RANGE HOOD ' <br /> ' WATEH HC 1TER ' <br /> • LAUNDHYTRAY � <br /> � , WOOD STOVE�, � <br /> + CLOTHES WASHEF � <br /> � URINAL ' METAL FIREPLACE 8 CH�MNEY ' <br /> � �FINKING FOUNTAIN i FIREPLACE INSERT � i <br /> ' � HEAT PUMP ' <br /> FLOOR GRAIN <br /> � BACKFI.OW PREVENTERS ; GAS PIPING � <br /> � ROOP DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � ' <br /> � — i <br /> � ' <br /> � ' <br /> � ' <br /> SUB TOTAL S ' SUB TOTAL S ' <br /> PEFiMIT $ � PtAMIT S � <br /> TOTAL FEE $ TOTAL FEE 5 ' <br /> Ff10NT5ETBACK FlEARSETB4CK SIDESETO�CN PLANCHECNNUMBER FEE REGEIPTNO. <br /> usezoHe LOTAREA V�CANTSRE FEES VAWATION FEE <br /> I::) YES f] NO BUiLDMG ' <br /> IYPE�F^OhSLALLOWABIE lYPEOfCONSi.ACIWL accUn�xcr xorrow[unIGU��S � <br /> GPO�� PLUMBING �_T <br /> SREOFBIDG NO.OFSiORIES BASEMENT MECHANICAL � <br /> f_I Y[S I I NO � <br /> OCCUPRNCVLOAD FIIIESPRNNLERS(1EOD NEIGHTLI1dI�ATION OTHER � <br /> I_1 YES I 1 NO STATE BUILDING SURCHARGE � <br /> i <br /> REASON FOR SPOINHLENS � <br /> STATEENERGVSURCHARGE � <br /> i <br /> nrri�cnncx��cc.av anr+snrrnoveoer CITYOFEVERETT PUBLICWORKS � <br /> LOCALSALES � <br /> TAl(CODE IS 3105 TOTAL <br />