Laserfiche WebLink
APPLICAT�N FOR CONSTRUC�ON PERMIT everett <br /> , ,. �E�� TO BE COIiPLETED IN INK—PLEASE PRINT � <br /> everett HEATING SYSTEM: O GAS ❑ELECTRIC ❑ <br /> `� BUILDING DEPARTMENT <br /> 259-8810 <br /> �j ❑ DEMOLITION I I COMBINATION i J BUILDING I ' ECHANICAL I ]PLUMBING 17 SI(iN <br /> pNRER 1MIL�DDRE55 dTY IP P110NE <br /> � _Srsl�/Ef /9Z2�c�.r�` �s� A�v/ 2r2 9�6z <br /> �wvn /.ua�ooness cm zir v� <br /> I1pLMTECTOROESqNER MAiI�DDRESS CRY ZIP PIIONE <br /> pENEpKCpNTq�lC7pp WIlADq1E55 ptY ZIP PIIONE LICENSE• <br /> MEpIN161N.COMTpACTOR M�IlWd1E55 dTY ZIP PIIONE LICENSEI <br /> 1 <br /> ►lUMlINp CONTR11CTq1 IMIL�DDRESS qTY IIP PHONE LILENSE� <br /> ` Os�c y .Yax�-.w` i9 •� G��r�.,. �'v 98'Pa�i' T��?!!2� lJu.<�.✓�i,�� <br /> 'cwa aF <br /> �jl'NEW CI ADDITION I-I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVEIFRPL INSERT ( 7 BUIlDIN6 RELOCATION <br /> CON7�CT PERSO�•W 0 P110NE NO. <br /> CONiMCT%110E OF WMM �� /Tl 7 <br /> pE�CRlE NOIM(NA BOUARE FOOT�OE MVOlVEO� <br /> ��� I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> Y C�IM�tiIC i6 t APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL ', <br /> 1F011L0EBCRFTqNOFPiqPERTV�51q'MIBELOWORATiACHFWPCOPIES� PROVISIONSOFUWSANDORDINANCESGOVERNINOTHIS7YPEOF i <br /> WORK WILL BE COMPLETED WIT11 WHETHER SPECIFIED HEREIN OR I <br /> aT �� �F NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE ' <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW REQULATINO CONSTRUCTION OR TIE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WMICH <br /> � APPUCATION IS MADE AND I COMPLY WITH THE STATE <br /> ,� CONTRACTORS LAW 1827 RCW AND 298.200 WAC. <br /> SION�TUREOFCONTMCTORORAUT/qRREDl1f3ENT WTE <br /> ; .�.,,�� Xi;r�� ���5��,� <br /> ; �a H��„n- ,��- <br /> KUMNIO MECHANICAL <br /> �� N0. TtlPE OF FlXTUNE ON ITEM FEE NO. TYPE OF ECUPMENT FEE <br /> '� WATER CLOSET(TOILET) � NC—NHNDLO UNITS�I.P. � <br /> ; 9ATHTUB ' FORCED AIH SYSTEMS—B.T.U. M E.A. ' <br /> � tAVATORV(WASH BASIN)� � UNIT HEATERS�-B.LU. M � <br /> SMOWER � CL07HES DRVERS � <br /> ' KITCHEN SINK 6 DISP � VENTIUTION FAN ' <br /> � DISMWASMER � RANGE HOpD � <br /> � LAUNDRVTRAY ; WATER HEATER ' <br /> � CLOTHES WASHER � WOOD STOVE � <br /> � URINAL ' METAL FIREPLACE d CHIMNEV ' <br /> DRINKINO FWNTAIN � FIREPLACE INSERT ' <br /> i <br /> i FLOOR DRAIN HEAT PUMP � <br /> �! BACKFLOW PREVENTERS ; OAS PIPING ' <br /> i ROOF DMINS—RAINLEADERS � EXHAUST FAN � <br /> � SINK(SERVICE—BAR,ETC.) ; ' <br /> � <br /> � � <br /> � i <br /> � � � <br /> � � � <br /> i <br /> i SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTAL FEE S ' TOTAL FEE S '� <br /> � FOR OFFlCE USE ONLY: <br /> � F110NTSETlACK RE�RSETBACR SIDESETBACN PLANCMECKNOMBER FEE REGEIPTNO. <br /> I <br /> i UBEZtlNE LOTAREA VACANiSITE FEES VALUATION FEE <br /> BUILDING i <br /> 1YIFOiLONiS.�LLOWABIE tYPE0/tONSt.AC1UAl �MMr xonUMti�xcuxns � <br /> °R0�° PLUMBING � <br /> &2EOFBLDO. NO.OFSiOR1E5 BASEMENt MECHANICAL � � � <br /> OCCUPANCYLOIID FIPESPRNNLENSRE00 NEK3HTUMITATION ADDITIONALPLANCHBCK � <br /> OTHER � <br /> i <br /> REI150N FOR SP111NKLERS <br /> STAiE BUILDING SURCHRRGE � <br /> i <br /> MTAI(EBY PUNSAPPROVEDBY CITYOFEVERETT PUBLICWORKS � <br /> LOCAL SALES � <br /> TAII CODE IS 9105 ror�� 30 � _ <br /> ,-.. .�• •,-_-,.-.�. _ . .. . _ _ . . ._. ,,. . , .,,_.. . ,. . _ ., . .. .. _.,�.... <br /> �;: <br />