Laserfiche WebLink
� APPLICATI N FOR CONSTRUC . 10N PERMIT e�,<<P« <br /> mee�e.gm�n TO BE COMPLETED IN INK—PLEASE PRINT � <br /> " cirv oF <br /> everett HEATING SYSTEM: iJ GAS U ELECTRIC J _ ---- ' <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> • DEMOLITION COMBINATION ��LDING MECHANICAL PLUMBING SIGN � <br /> .. � OWHER D� Ccr��ehi�DDFESI��� � Ci1V ZiPj� _ I—� PHONE /�✓i/ �V""`„ I V/'�.D <br /> �Kj 4J <br /> iO.�NI MRILADDflE55 CIiY 21P PNO E I <br /> CIiY 2'v PHONE � <br /> ARCNIiECTOR�E5IGNER MRRP�DRE55 � <br /> +[N[RALCO4IR CT� IAIL� [55 �����UI�I� ZIP/���� PNON �� �/ � LILEH�����I��� . <br /> r�I"i�� � '/ `M <br /> MEQUNiCALGONinACIDP MAiLA��RE55 ' Citv ZiP PNONE UGENSE• <br /> C�1 y <br /> ��H �'1UM01NGCONiRAC10R AIMIADDRE55 GiV T�P PIIONE LICENSEI <br /> ay�n <br /> H �� CLRSS OF WORN � <br /> � NEW � ADOITION ALTERATION �EPAIR � DEMOLITION WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br /> � y� . � CO ACTPERSONANDF�� IEtlO ^^, —��0� <br /> � y H CONiR4CT PiiILE OF WORN ' <br /> �'d D .00 o�Yv <br /> � O f-1 CRIpE WORN AND IIRR[FOO1A E INVOLVEO �� — <br /> iy �� <br /> t� <br /> y C y r oa osmuse ro ILDING I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS <br /> � �(Jy[ hi' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> �"� �`�+ LGAL E�` IPT�ONOFPROPERTVISNOIVNBEIOWORATTACMFOUNCOPI[51 PROVISIONSOFLAWSANDOFDINANCESGOVERNING7HISTVPEOF <br /> �� n WORK WILL BE COMPLETED WITH WHEiHER SPECIFIED HEREIN OR <br /> a y� iot_�,_ oiaNa4 a oF NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � Z � Ills101� OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> y H PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PEflFORM TNE WORK FOR WHICH <br /> � tyy APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTOq$LAW 18.27 RCW AND 296200 WAC. <br /> � �r SIGNAiUPE0FCd11 ACTOROPRUTNORiZEDAGEN �ATE <br /> y w — � 7�'�� <br /> H O tn �(�' � �� � / <br /> i � � <br /> PPOJECT DORE55 <br /> pFP}CA TSGIiY9U5iNE5 LCE [t0 ANpBU5ME55BnME <br /> �f.'n� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) NC—lUHNDLG UNITS—H.P. <br /> �' � BATHTUB FORCED AIR SYSTEAIS—B.T.U. M E.A. <br /> !� LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHES DRYERS '� <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> � RANGEHOOD <br /> � 1� DISHWASHER — <br /> w 4 LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WO�D STOVE <br /> � � URINAL METAL FIREPLACE 8 CHIMNEY <br /> !� DRINKING FOUNTAIN FIREPLACE INSERT . <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING <br /> `� E%HAUST FAN <br /> I�! � ROOF DRAINS—RAINLEADERS <br /> � SINK IScRVICE—BAH,ETC.) <br /> 5� I <br /> �„!,� <br /> i <br /> SUB TOTAL 5 SUB TOTAL 3 � <br /> ! � PER1.11T S PERMIT 5 <br /> '! TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> ' /� FRONtS[TOACK RE�RSEiBACN S�DESETBACN PUHOIELNNUGBER FEE AECEIPiNO <br /> usezcr+e �otnnEn VALANTSITE FEES VALUATION FEE <br /> BUILDING ��� � <br /> iv�[OfCONiSAIlOWR7lE n"PFOiGONSi.�titlat a<u>un eoam�lu�xcu�:5 <br /> cvou> p�UlABING <br /> Si1[OFBLOG ���OFSTORIES Pr1SEMENT MECHANICAL <br /> O(:CUPANCYIOAD Fill[SPPNKIERSREO'D MEIG�ITIIMitAT�ON ADDITIONALPIANCHECK i <br /> OTHER L �� 1 <br /> RLASDN f ON SPlIINMlERS <br /> STATE DUIl01NG SURCHARGE <br /> iranrceor �LINSAPPRCV[ODV CITYOFEVERETT Pl10lICWORNS � <br /> LOCALSALES <br /> � TAX CO�E IS 3105 rorni 7 ,S j�, <br />