Laserfiche WebLink
i �.-.� .-� <br /> APPLICATION FOR CONSTRUCTIaiN PERMIT <br /> Ihe Evergreen everett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-BB10 TO BE COMPLETED IN INK—PLEASE PRINT <br /> I-1 DEMOLITION I I COMBINATION I i BUILDING I i MECHANICAL i I pLUMBING I I SIGN <br /> o�'�SNV �9�f� .Z66ussPa�v��rcwr������1 ��.� /I�� zm48�3 r�i355 - �77% <br /> TENANT MAIIADORE55 CIIY iIP PHOHE <br /> ARLHITECTORUESIGNER MAllA0DRE55 GIIY 7.IP PNONF <br /> GENERAL CONTRRCTOfi MAIL AO�PESS CIIY 21P PIIONE �ICENSE t <br /> ECH�NIC�LCONTqRCTOR h1AILqU0RE5S CIiY ZIP PIIONE LICENSE� <br /> �IIIq1uRRI G�s C�UiPN��n� 16as E•Ml1RINL- 1/1�i.0 , L�1 �g' �5 S1-�44 <br /> PLUMBINGCONiRaOTpR MMLADDPESS CITY 21P PNONE ICENSE'1 //^�'7 <br /> V� <br /> CUSS OF WORK <br /> ♦♦♦ ��' f1 NEW C 1 ADDITION !,I ALTERATION I I REPAIR � I DEMOLITION � I WOODSTOVE/FRPL INSERT i I BUILDING RELOCATION <br /> � TEN�NTIMPHOVEMENfOf11NTERIOfiREMODELONLY CONTACiP'�iSON4NOP110N[NO. <br /> CONTRACT PRICE OF WOFN: �SDU'O U <br /> DESCRIBE WORN AND SOU4RE FOOTRGE INVOLVEU <br /> u a OSEDUSEOFBUIIDI G I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � 71Y�' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEOALOESCP:PTIONOFPROPERtt�S110WNBELOWOf1�TTACNFOUBCOPIES� PROVISIONSOFLAWSANDOROINANCESGOVGRNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or eiocr. �oF NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI 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 TIiIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS t.AW 1827 RCW AND 296.200 WAC. <br /> SIGNTIUREOFCONIP4C70ROfi�UTHOOREDAGENT O�IE <br /> PRQIECTAODR 5 /J <br /> X ` <br /> � �608 ����r�w g�,�� L�L�� ��/} `j��D� APPLI TSC`V�SINE SLIC�EN0 / DBUSINESSNAME <br /> PLUMBING MECHANICAL � <br /> � NO. TVPE OF FIXTURE OF ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> ' WATER CLOSET(TOILET) � A/C—/UHNDLG UNITS—H.P. , <br /> BATHTUB ; � FORCEDAIRSYSTEMS—B.T.U. M E.A. SOG Y�O <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; _� WATERHEATER y � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIAEPLACE INSERT ; <br /> FLOOR DRAIN FIEAT PUMP � <br /> BACKFLOW PREVENTERS ; _� GAS PIPING � ; <br /> ! ROOF DRAINS—RAINLEADERS � EXHi\UST FAN , <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> -- ; <br /> _ <br /> � � <br /> � — , <br /> � , <br /> --�—— <br /> i <br /> SUB TOTAL $ � SUB TOTAL $ � <br /> PERMIT 3 � PERMIT $ ; <br /> TOTAL FEE $ ' TOTAL FEE 5 � <br /> FRONiSETBRCK REAPSETBRCK SIDESETOACK PWlCHECKNU�ABER FEE FECEIPTNO, <br /> USEZONE �otnae,� VACANiSITE FEES VALUATION FEE <br /> I I YES I I NO pUILUiNG ; <br /> IYPEOiCON5i.,1LLOW�BIE IYfEOf�CN5tAC1VAL oc[uvu¢v HOaowluiNGux�u <br /> LpWP PLUMBIIJG � <br /> SIZEOF�LO(3. NOOFSTOOIES O45EMF.N� M[CIIANICAL —T <br /> I I YES I I NO — — � <br /> OCCUPANC�IOpD FlRESPRNNLEPSREO'D IIEIGM7LIAlIiAiION OTHER � <br /> I I YES I I NO STA7EUUILDINGSURCHARGE i <br /> REASON FOR Sf RINNLERS � <br /> STAiEENERGYSUFCHARGE � <br /> APPUCATIONAGC.DV PLANSAPPROVEDBY CITYOFEVERETT PUBLICWORKS � <br /> LOCALSALES ' <br /> TAX CUDEIS 3105 TOTAL ; <br />