Laserfiche WebLink
, . , , . .. _ _ • ._,___.....,: . � .._.... <br />APPLICA710h FOR CONSTRUCTII,N PERMIT everett � <br />�� E���� TO BE COMPLETED IN INK—PLEASE PRINT � ; <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />f:] DEMOLITION I I COMBINATION <br />OWNEfl ./• MnIL nODRE55 (� <br />��L�/L.E;/�/�l�.s/Lti�4� / r L�� <br />i i BUILDING <br />CITV <br />i�Y�KIi}X �f'� <br />arr <br />i•. <br />� <br />I I MECHANICAL �✓hLUMBING I I SIGN � <br />zir PHONE <br />i �Z��� <br />ARCHITECTORDESIGNER M�ILADOfiESS CITV 21P PNONE <br />GENER LCONTMCiOR MAILAD�HESS GITY ZIP PNONE UCENSEI <br />�i27�L�> �c+�P <br />MECH�NICAL CON� MAIt AODflESS CITV 21P PHOHE IICENSE I <br />PLU�MBjIN�G CONTRACTOR MAIL ADDRESS GTV 21P PHONE UCENSE � <br />� vG{ S�LU�i 3M/C f U(jf �J( /�j % A-�vc�-.k� /`,( z5� �-.3`{/� �X'� �TD�'I J' Z3S%,CC Z._ <br />cuss oF woeK <br />I� NEW ❑ ADDITION f, ALTERATION I� I REPAIR I.I ^FMOLITION I. I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />CONiACT PERSON AND PIIONE NO <br />WORK ANO SOUARE <br />LEG�L �ESCRI^TION OF PROPEFN ISHOWN BELOW <br />lOT . BIOCK OF <br />IQIECTADORESS <br />�G -�/i' �d�Cf �� /L <br />PLUMBING <br />N0. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET lTOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN)� <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />UFiINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />FOR OFFICE USE ONLY: <br />FRONTSETBRCN PEARSETBA( <br />�SEZONE ��TAREA <br />TYPf Of CONiS. ALlOWABLE ttPE OF LONSi. <br />SREOFOLDi�. NO.OFSTORI <br />OCLI1Pr1NCYlO�L FIRESPPNKII <br />FEASON FOR SPRINKLERS <br />INT�KE BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIPlG THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOiiITY TO VIOLATE OR CANCEL 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 296200 WAC. <br />SIGNATUREOF ONiRFCTOR0f1AUiHOHIZEDAGENT DATE <br />i n <br />X �c�/ � 7�/ 9/ <br />APPLIC S CITY BlI51NE5S LILENSE NO. �ND BUSINE55 NAME <br />NO. TYPE OF EOUIPM <br />� A/C—A/HNOLG UNITS—H,P. <br />FORCED AIR SYSTEMS—B: <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />SUB TOTAL $ _� � — <br />PERMIT $ � <br />TOTAL FEE $ � ' � <br />SIDE SETBACK <br />VACANT SITE <br />PUNS APPfiOVED BV <br />FIREPLACE IN'� <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />CHECN NUAIBER <br />BUILOING <br />IX[uf�N[v x�IXOw[umGUxrtS <br />�"�1° PLUMBING <br />OaSEMENT MECHANICAL <br />IIEIGIITLIMITpTION ADDITIONALPLANCHEGK <br />OTHER <br />STATE BUILOING SUPCHARGE <br />CITY OF EYERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 T�TAL <br />8 CHIMNEY <br />TOTAL 3 <br />�IIT $ <br />1L FEE $ <br />e <br />a <br />