Laserfiche WebLink
APPLICATIC 1 FOR CONSTRUCTl7N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDINC DEPARTMENT HEATInG SYSTEM: GAS iJ ELECTRIC ❑ <br /> 259-8810 <br /> f� DEMOLITION f7 COMBINATION !_i BUILDING �LMECHANICAL � PLUMBING �! SIGN <br /> (�Y�'NER � 1dAILA0DRE55 <br /> � � ZIP <br /> PMONE <br /> �,, ���r�,<�y, 75�i � �e�-� �tkE, E� � q�;�r �3 �� ��5'�;' <br /> TEN \I i MqILA0�FE55 � CItV � ZiP <br /> PHONE <br /> .i <br /> ARCHITECTOflDESIGNER IAqI�ADORE55 CITV Zip <br /> PHOtlE <br /> GENERALCONTRACTOR 61pI�qODqESS CITV ZIP <br /> FHONE SiATE LIGENSE R <br /> Id NANICRLCONTfl/CTO MqILAD�RE55 '/� <br /> I'1 l'J•— J,,'J!ry I� I �'IP PHONE STATE LILENSE e <br /> � P"�- h�` :����� 1 G� ,�t� � ��z ��(p -'75-��3/�� �5��'ia�ii1�h` <br /> PLUM9INGCONTRACTOR 1 MqILA00RE55 Z�P <br /> �.. / , PNONE STATE LICENSE u <br /> !/t��n <br /> !� �� <br /> LONTRACTPRICEOFWORK IL ��� <br /> DESLRIBE WOFK qNO50UARE FOOTAGE INVOLVED <br /> CONTqCT PERSON ANO PHONE NQ � <br /> ��— U l � , � m o� .i_ � �rr�� �7S 7,3/� <br /> ; . <br /> vaoaoseouseoFem�o�Nc I HEREBY CEf?TIFV THAT I HAVE READ AND EXAMWED THIS <br /> APPLICATION AND KNOW THE SAME TO 9E TRUE AND CORRECT.ALL <br /> IEGAL0E5CRIPTIONOFPqOPERTV�SNOWNBELOWOFATTpCHT1Y000PIES� WORKCWILLSBEFCOMPLETED WIDTIH WHET ERVS ECNFIEDHHE EPN OR <br /> �or d�aK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br /> AUTHORITY TO VICLATE OR CANCEL THE PqOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> P[RFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OV/NER OF THIS PROPER7Y TO FEAFORM THE WORK FOR WH;CH <br /> anace�rnxi.o.NUMoeR APPLICATION IS Iv1ADE AND I COMPLV WIiH �iHE g7ATE <br /> CONTRACTOqS LAW 18.27 RCW AND 296200 WAC. <br /> CGNSTRUCTION LOAN LENOER.A�OHESS.TELEPHONE NUMBER /l <br /> ` � ^ ��2'r�� ^' <br /> PROJECTADDRESS� _ � 7 �n e � � ��`�� onrc <br /> r i•1 <br /> / n . crtvquS46s11[ENSENo ' <br /> PLUMBING `" MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMEN? <br /> WATER CLOSET(TOILET) FEE <br /> A;�C—AiHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASHBASW) UNITHEATERS—B.T.U. M <br /> _ SHOWEFi � CLOTHES DRYERS <br /> KIICHEN SINK 3 DISP VENTILATION FAN � <br /> DISHWASHER RANGE HOOD — <br /> LAUNDRYTRAY ( WATER HEATEF <br /> CLOTHES WASHER WOOD S70VE <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREP!ACE INSERT <br /> FLOOR DRAIN HEAT PUMP '—"— <br /> _ BACKFLOW PREVENTEfiS i GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � — <br /> � <br /> SUB TOTAL g SUB TOTAL S /� I <br /> _ PERMIT 5 PERMIT S .� �— <br /> TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE US�ONLY: <br /> FqONT5ET6ACN qEAP.5ET8lCK SI�ESETB4CR P�ANCHECNIIL4A9Eq FEE RECEIPTNO <br /> y�s�� <br /> usezoNe �ornaen vncnrvrsire FEES VALUATION FEE <br /> !^' YES ❑ NO BUILDING � <br /> iYPEOFCONSi ND_OFSTORIES ppwvnutv uOorCafwNsuwiS <br /> GAR�.n � --- ' <br /> PLUMBING i <br /> SREOFBLpG. FIfiESPRINKLERSREO'D 9q5EMENT <br /> ❑ YES IJ NO MECHANICAL <br /> OCCl1PANCY LOAD FIqE ALARid REOD MEIGHT LIM�TATION �DDITIONAL PIJ�N CHECK <br /> �[nsoN OTNER <br /> STATE BUILOING SURCHARGE � <br /> INiaRE BY PlANS nPvppyEDBV CITY OF EVERETT P�BLIC WORKS � <br /> LOCAL SALES <br /> OFTE TAX CODE IS 3105 TOTAL <br />