Laserfiche WebLink
APPLICATI� FOR CONSTRUC7 .DN PERMIT <br /> �E�� everett <br /> cm oF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL �LUMBING ❑ SIGN <br /> PWNEfl M A E55 CITY / pZIP p PMONE <br /> L�GC�c t��l � b b � / 9 ('LLaYdrdlaf��»ri /�t�f� �✓P r�� �/�� <br /> TENANT MAIL ADDRESS CITV ZIP PMONE <br /> z <br /> ARCMI C OR DESIGNER M� RE ZIP PHO <br /> �" �- ��0 - <br /> G NERILLCONTMCTOR IL D ESS f,ITY ZIP PHONE LICENSEt <br /> � l�{�r� �-�G� �l�k� � .s-��, �/,o_ 9�i cs .�s.�cr� <br /> ��ME !UN QCONTiU R ILADDRESS CITV ZIP PMON UCENSE� <br /> :5.��� `�1.,��,�;�,� S�a.� .�K,��_�i,� lll�. ��,/,� ro.s�_9,��.� <br /> PIUMBINOCONTRl1CTOR MAILADDRESST � ZIP � PHONE —TrICENSEI <br /> �JG7l'�/��i�1�� <br /> cuss oF wonK � <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDINO RELOCATION <br /> TENIINT MPROVEMENT Ofl INTERIOR REMODEL ONLY CONTACT PEHSON�ND PHONE NO. <br /> CONTAACT PRICE OF WOPK: <br /> DESCRIBE WORK/1ND SOUARE FOOTAGE INVOLVED <br /> rnorosEouseoFeunnrtw I HEREBY CEHTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � LEQLL DESCRIPTKKi OF PROPER7Y�SNOWN BELOW OR ATT�CN FWR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF . <br /> . WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT eioac__ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED AY THE <br /> -� OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ` CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> ' SIONAPJREOFCONTfl�CTORORAUTHOR2EDA0ENT DATE <br /> X <br /> 1 PROJECTADDRESS <br /> ` � /� � APPLIG�NTSCITVBUSMESSLICENSENO.ANDBUSINESSNMIE <br /> d- <br /> PLUM&NO MECHANICAL <br /> �� NO, TYPE OF FlXTUNE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> . WATER CLOSET(TOILEn � A/C—A/HNDLG UNITS—H.P. � <br /> �, gp�{7�g ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> UVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS T— <br /> � KITCHEN SINK 6 DISP � VENTILATION FAN ; <br /> . DISHWASHER � RANGE HOOD � <br /> . LAUNDRV YRAY ; WATER HEATER <br /> ' CLOTHES WASHER WOOD STOVE � <br /> ' URINAL ' METAL FIREPIACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FiREPLACE INSERT � <br /> - FLOOR DRAIN � HBAT FJMP � <br /> , CACKROW PREVENTERS ; GAS PIPING �_ <br /> RC OF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> �. SII iK(SERVICE--BAR,ET0.) � � <br /> � <br /> � � <br /> — � � <br /> � � <br /> � � <br /> , � <br /> ' SUB TOTI:L S ; SUB T'JTAL $ <br /> PERMIT $ � PER!dIT S �_ <br /> TOTAL FEE $ : iGTAL FEE $ � <br /> FRONT SETBACK REAq SETBACK SIDE SETBAGK PLAN CMECK NUMBER FEE RECEIPT NO. <br /> USEZONE IOTAREA VACANTSITE FEES VALUATION FEE <br /> G VES �] NO BUILDING . � <br /> ne�orca+srnuow�e�E rmearcoxst.�cru�i ���r xooro�nurocun — , <br /> eawe pLUMPING L� � � <br /> SIZEOFBLDG. NO.OFSTORIES BASEMEN7 MECIIANICAL �'��� <br /> ❑ YES C� NO � <br /> OGCUMNCVLOAO FIRESPRNKLERSREO'0 HEIGMTLIMITATION OTHER ' � <br /> __...�� <br /> Ll YES � NO STATE9UILDIMGSURCH4RGE ' <br /> REASON FOR SPRINK�ERS <br /> STATEENERGYSURCHARGE i <br /> i <br /> APPLIGATION�GC.BV PLANSAPPflOVEDBV CITYOFEYERETT PUBIICWORKS � <br /> i <br /> LOCAL SALES T— <br /> TAX CODE IS 3105 mra� Ij �,� <br />