Laserfiche WebLink
APPLICATIO.. FOR CO1�lSTRUCT�.lN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS iJ ELECTRIC J _ ____.� <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> 05YNER MAIIADDRE55 CrtY ZIP PMONE <br /> TiMe771Y StoDbKL /Ghl GWKS___�Er/E�C73' 98701 �SL-02y�/ <br /> iENANT MAiLADDRESS CIiY 21P PNONE <br /> .1qCMITEGTORDE51GNEfi l.IAiLADDRE55 GIiV 21P PHONE <br /> �] GENERRICONiPACTOR IAARADDRE55 CITY IiP PHONE SiATELICENSE� • <br /> �r�y� <br /> pa'y S`�y'f[GNANICAICONTqACTOR MAIIADDRESS CIiY ZiP PHOflE ST4TELICENSEe <br /> p�x ,�WEr..� f+�5ar,nL �.zoZ '�f� L'..//EtnJur�J�� 98ao/ �'S3-33`1�/ �yu��/o95bL <br /> �y�Z'�/] PLUMpINGCONTRACTOR AIAiLApDR[55 Cliv 21P PHONE SiATELICENS[e <br /> H ?3' <br /> y x�"� CLASS OF WORK <br /> � y�,�q NEW ADDITION X ALTEFATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATIOM <br /> � H� �n CONTACi PERSONAN�/DPHON[tl0 �/ '/ <br /> y~ COfJiRACT PRiCE OF WOPK Iu/�/ �/7 ��7 %J3 j ] <br /> 'j� OESCRIDE 1'lOfiN AN�SOUAFE FOOtAGE INVOIVC� <br /> H - <br /> � �d Gft.S �°o,dd��o.J <br /> p H PHoaos�usE oF ounoirvc APPL CATION AND HNOW THE SAMEETO BE TRUE AND CORRECT.ALL <br /> �,�,�� �,�,y <br /> ��C] PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGAI OESCFIPiiON UF FROPERiV�SNOWN BEIOW OR RT7ACM FOVR COPiE51 <br /> � y� WORK WILL BE COh1PLETED WITH WIIETHER SPECIFIED HEREIN OR <br /> ior BLOCK oF NOC THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> H y AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OfHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> y N PERFORIdA�.ICE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> n d y 01NNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � [�r — — AFPLICATION IS h1ADE AND I COAIPLY WITH THE STATE <br /> Z y y CONTRACTORS LAW 182'PCW AND 296200 WAC. <br /> H O V� <br /> �/,�f�'!/ /O-7G-9L <br /> rrwecraoon[ss —�— -- — .�.�' l �� r��s:�. <br /> /� oa K-S Ar/• �L73_SS -- <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEh1 FEE NO. TVPE OF EQUIPMENT FEE <br /> �_ WATER CLOSET�TOIl.ETI A C-A HNDIG UNITS-H P <br /> � ' BATHTU� __L FORCED AIR SVSTEIdS-BS.0 �d EA. <br /> � LAVATORY IINASH�ASIN) UNIT HEAT[RS-8.T U. M <br /> SHOW[R CLOTh{ES DRVERS <br /> `o ti KITCHEN SINK 8 DISP VENTIL/1TION FAN <br /> !� DISHWASHER FANGE HOOD <br /> LAUNDRY TRAY WATER H[ATE(i <br /> CLOTHES WASHEfi WOOD STOVE <br /> URINAL h1ETAL FIREPLACE 8 CHIMNEY <br /> a+ DRINKING fOUNTAIN FIREFL�CE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> ��� BACKFLOW PREVENTERS ; _jL GAS PIPING <br /> �'� ROOFDRAINS-RAWLEADEPS —r- EXHAUSTFAN <br /> SINK(SERVICE-�AR.ETC.) <br /> �— _ <br /> � <br /> �� — - <br /> _ �— <br /> ��. SUB TOTAL S ' SUB TOTAL 5 ,3a <br /> !'� PERIdIT 5 —T- PERMIT 5 /� � <br /> TOTALFEE 5 TOTALFEE 5 � <br /> FOR OFFICE USE ONLY: <br /> � FRONTSETO�CK PERRSLTOACN 510[S[T04CK PIANCnCCNNUlpE1E❑ FlF. R[CEIPTNO. <br /> �f - :T ���/.� <br /> usezor�e IOiAREA vncnNrsire FEES VALUATION FEE <br /> �UIIDING <br /> 1vPF0iLONiSALLOWABIE IYP[OfL0115IALIUAI OCcuPexn Noq(w,uir.,i�.�,,. — <br /> �aP''P PLUMBING <br /> S�ZEOFBIDG. NOAFSTORI[S BASEMENi lAECHANICAI <br /> yr <br /> OCCOPANCV LOhD FlNE SPRNNLERS REOD MbGlrt UMIt4TION �D�ITIONAL PLAN CHECK <br /> SPRINKLEfi <br /> ncnso��ron srniNx�ens —}— <br /> STATE UUIIDING SURCHARGE <br /> rtnnnc nv rinr,snavnoveom CITY OF EVERETT Puouc WonKs <br /> LOCALSALES <br /> TAX f.OUE IS 3105 TOTAL <br />