Laserfiche WebLink
� • � APPLICAT�N FOI� CONSTRUC�ION PERMIT everett <br /> � ��E�ro�� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ,� citv oF <br /> everett HEATING SYSTEM: O GAS U ELECTRIC U <br /> 1 BUILDING DEPARTMENT <br /> '1 259-8810 <br /> i ❑ DEMOLITION I 1 COMB!NATION f l BUILDING V(MECHANICA�_ f 7 PLUMBING Ll SIGN <br /> O ER lAAIL ADDRE55 I�� G�7Y 21P PHONE <br /> ' _ P�• � uPr�Si `� ��e��c �Q ��-��r�w�- wr� asa-ys�o <br /> 7ENANT MAILADOPE55 CITY ZIP PIIONE <br /> �i ARCHITECTOROESIGNER MAILAU�RESS GITV 21P PMONE <br /> OENER�LCONTRACTOR MAILAODRE55 CITY ZIP PHONE LICENSEI <br /> � <br /> } MECHANIGICONTR�CTOR MAILADDRESS CITY 21P PNONE � S1' $fI IICENSEt <br /> � 11�4a$ht'�(�l�A'� ��1F��lrf��`�� ���Z SrC �C�t.a� ' nl/-� �� �LI �=US( 1�C20� loAs�a�nC d8sc <br /> PLUMBINOCONTH�CTOR M�ILADDRE55 CIiY ZIP P��ONE LICENSE� <br /> ' C1A550FWONK <br /> •� ❑ NEW I�Q ADDIT�ON I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I 1 BUILDING RELOCAT�ON <br /> / CONiACt PE(150N AND PIIONE NO. <br /> C �OCONTR�CTPPICEOFWORB �� <br /> OESCRIBE WORK 11NU SOU�RE FOOUGE INVOLVED /I� I 1` <br /> � ZrS�a�\ S 20 � T I ne <br /> .j PROPOSEDUSEOFBLiIDINc _ � � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> v APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEWL�ESGRIPTIONOFPROFERTY�SHOWNBELOWORATTACNFOUIiGOPIES� �ROVISIONSOFLAWSANDORDINANCESGOVEPNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot e�ocK oF NOT. THE GRANTING 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 THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGNATUREOFCONTRRCTORORAUTNOP2EOAGENT DATE <br /> X _—�� �� I 2- 7� �D <br /> PHQIECT�DORE55 ( <br /> ¢� ��. � � �PVLICANISGITYBUSINESSLICENSENORNDOUSINESSNpME <br /> � <br /> �• PLUMBINQ MECHANICAL <br /> �� NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> ' WATER CLOSET(TOILET) � NC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORV(WASH 6ASIN) � UNIT HEATERS—B.T.U. M � <br /> � CLOTHES DRYERS ' <br /> SHOWER • _ <br /> KITCHEN SINK 8 DISP __�_ VENTILATION F�N T_ <br /> DISHWASHER � fiANGE HOOD ' <br /> LALI�DRY TRAY ; WATER HEATER ' <br /> CLCTHES WASHER � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT __� <br /> FLOOR DRAIN � HEAT PUMF �_ <br /> BACKFLOVJ PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADEPS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) ' �' <br /> � , <br /> � T <br /> � � <br /> 1 <br /> 1 � <br /> 1 � <br /> SUB TOTAL $ ' SUB TOTAL 3 ' <br /> PERMIT $ PERMIT $ / � <br /> TOTAL FEE $ 70TAL FEE ' <br /> FOR OFFICE USE ONLY: <br /> FPONT SE78ACR REAR SE7B�CK SIOE SETUACN PLAN CHECY,NUMBER FEE REGEIPi NO. <br /> UFE20NE LOTAREA ��CANTSIIE FEES VALUATION FEE <br /> BUILDING ' <br /> iYPEOFCONiS.RLIOWABIE IYPfOFLONSI.ACNAI 11uur1v[r NaaNalUxGuxnS � <br /> cnav p�UM�ING i <br /> SIZE OF OLDG. NO.OF STORIES OnSEMENI � <br /> MECHANICAL �('/ �f'�'—' <br /> � <br /> OCCUPANCYLORO FIRESPIiNKLER5f1E0'� MEIGHiI�u�innoN � �DDITIONALPLANCHf:CK i <br /> i <br /> OTHER � <br /> REASON FOfl SPPINKLEi15 i <br /> STAiE BUII.OING SURCHARGE � <br /> � <br /> INiAKEBY PUNSAPP(10VEDOV CIiYOFEVERETT PUBLICWORKS � <br /> LOCALSALES , <br /> TAX CODE IS 3105 TOTAL ,y��— <br />