Laserfiche WebLink
\ <br /> APPL1I..�TION FOR CONSTF,�JCTION �1 �' <br /> PERMIT � <br /> mo 6rorgrcen <br /> CITY OF �rv�•rcll <br /> everett e <br /> �UILDING DEPARTMENT <br /> 259�8870 TO BE COMPLETED IN INK- PLEASE PRINT <br /> owrvca n�ai�nooncss cnr � vH�.� <br /> :SPrC K ('�Ili.4h -��,3�1 �`=�"-��(�-('1t��� I ,�`�� -- (�',�k� <br /> ILNAN �,IRiLAO�— CRY IP PHONE - <br /> ��/Yti�� <br /> AfiC111LEGTORDE51G4ER MAILADORE55 CIiY ZIP PMONE � <br /> �r� <br /> G N RALCONfRACiOP I,IAILN� FE55 [IT jIP 1�t0� �ICENSC• <br /> ,��x ��1�r ��� �' �T �� — � <br /> G H M[CNANILAICONi CtOP UAILA�DRE 5 GiY P P�1ON�E �/�.� ` �I(�NS/} <br /> r r`t� �L�,i�il v�'/J��'1.— <br /> H � PLUM6INGCOMPPGIOR MRILAppPE55 LiiY ZIP P��ON[ �i�LN <br /> y �H �.�1;3--�C <br /> � y� CLASSOG WORK <br /> � H� ❑ NEW ❑ ADDITION��RATION ❑ REPAIP ❑ OEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> y yt~-1 t[NnNTI1.IPPOVEMENTORINi[RIORREMOOELONL I CONi4CTPEPSONANOPHONENO <br /> z <br /> l �� <br /> � p� LONTRACTPRI�EO�K'OFn ����i����� <br /> O H� �I�A�BEWORrc DS VAaE`pOlaGEi�+vO�/�EnD �^1 � e � ,�� <br /> 7tl C]�][y �_�fL���� V l�l'��� �� <br /> �"'� ��+ PROPO E�USEOFB t DING - <br /> H� O _ -��/ IHEREBVCERTIFYTNATIHFVEREADANDE%AMINEDTHISAPPUCATIONAND <br /> \1� KNOW TME SAMETO BE TFUEAND CORRECT.ALL PROVISIJNSOF LAWSAND <br /> 9HtEGn�oescr+ivnOr�ovanoaesrv�s��rnvrveEiowoanri.erroueCOPiEs ORDINANCESGOVERNINGTHISTVPEOFWORKWILLBECOh1PLETEDWITH <br /> ty � WHETHERSP[CIPIEDHEREINOANOT.THEGRANTINGOFFPERAIITDOESNOi <br /> HH lor B�OtK or PFESUMETOGNEAUTHORITYTOVIOLATEORCANCELTHEPROVISIONSOF <br /> � y - ANVOTFIERSTATEORLOCALLA4VREGULATINGCONSTRUCTIONOPiHEPER� <br /> �..� FORb�ANCE OF CONSTRUCTION.THAT I Atd AUTHORIZEO BY THE OVJNER OF <br /> n dy THISPROPEHTVTOPERFORMTHELYORKFOR\VHICMAPPLIC4TIONISMADE <br /> C,' AND I COh1PLV WITH THE STATE CONTRACTJRS LA1N 1827 PCLV AND <br /> 3 C'� 296 200 WAC. <br /> zyN _ __ s�varun[ormvrancron +�..umu�azronccnt �ar <br /> �3 o cn X �A// �' /� /5� <br /> FPOJECtAppRE55 / 1 � / pl ,��;ti�.j,}55` ' .��:J<'�D�11�55NP��� � -- <br /> a . c���� � v <br /> PLUM6ING MECMANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATER LLOSET(TOILET) A�G-A'HNOLG UNITS-HP. <br /> � -. _ _. .__--____.. ___ - . _ _-_ __ _. ___ <br /> �1 BATHTUB ' FORCED.IRSYSTGL75-BS.0 EA <br /> �_- _-_'_.----_'__ _-'_".- _-- _ - _ . _ _ _ . _.. _. _ _ -'- <br /> LAVATORVpYASHBASIW UNITHEATERS�-�S.0 A1 <br /> SHOWER CLOTHESDRYERS <br /> '�v �� KITCHENSINKBDISR _ __ VENTILATIONFAN _ <br /> ,M, '1 __ DISHWASMER RANGEHOOD � <br /> LAUNDRY TRAY WAIER HEATER <br /> -'_ _-__ - <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPI.ACE 8 CHIMNEV <br /> �"� �RINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR ORAIN /^� MEAT PUMP <br /> '.�.. � _ BACKfLOW PREVENTERS _ _ _!"Y� GAS PIPING _ <br /> �I� F700FORAINS-R1INLEADERS � E%HAUSTFAN <br /> SiNK�SEFVICE-BAR,ETf.I <br /> ,.*a — <br /> �^�r <br /> � <br /> ' I� _ SUBTOTAL S SUBTOiAL $ r - <br /> — '-_ -_—" __-_ -" �— <br /> __ PHRMIT 5 PERht1T $ � �- <br /> . � <br /> _--___ ._ .__ -.-_.___"._. __ .--_-__ "_-_ - . _ <br /> TOTALFEE S TOTALFEE S �1 ^ <br /> . fNONt5E10AGN iVE<RSCipACN SIpE5Ct13nGK PUNCNECNNUMBE(I fEE RECEIV�NO. <br /> usezor�c �ptanu vaC�Ntsne PEES VALUATION FEE <br /> u Y[5 ;: NO <br /> tYF60fCONR. OGGUP�NCYGNOUP NOOFDWELLINGUNRS BUILDING <br /> -___"_' '"-__"_ _-. ___- _ ---- — <br /> aLLOWABLC/ACTU�L <br /> PWMBING <br /> St[oFOLDG NoovsioWES 4tiM1. OCGIo�o — -- <br /> ❑� MECMANICAL �= <br /> C N <br /> rrtic�aurartenoN OTHER <br /> ru:c saniHK�EpsaEomnEo n rEs n Ho STATE BUILDING SURCHARGE <br /> STATE ENERGV SURCHARGE <br /> PVPlIC4ilON�CL.BY PUNSAPPqBY — <br /> PUBLIC WORKS <br /> TOTAL ,•� � <br /> i <br />