Laserfiche WebLink
APPLICATIO. FOR CONSTRUCTt � N PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS ,�ELECTRIC J _-� <br /> 259-8810 <br /> ( j DEMOUTION i I COMBINATION � BUILDING MECHANICAL ' ' PLUMBING SIGN <br /> `QWN[R J ldAILA�DAESS Y PN E <br /> �t��.���rr,r���� �)3/ ����,n.xo�r l��c� i�J �%�U3 ,�'��� 2� 7c� <br /> iENA. i lAAILADORESS � CI7Y 21P PHONE <br /> ARCMIlEGiOR[1ESIGNER AIAILA�OIiE55 GTY 21P PMONE <br /> GCN[RALC Tf1ACT0fi MNLADDRESS CITY 21P PHONE ST�iELICENSE� <br /> �rJ.�r �i <br /> IdECNANIC�LCONTR�CtOR MAILADORESS GITV 21P PMONE STFTELICENSEs <br /> PLUM1I�INGCONTIlAC10R MnILA�ORESS CITV ZIP PMONE ST�1ElICENSE• <br /> GONTR4CT 1'RIGE OF WORK <br /> �ESCRIBE\VOPK AN�SOU4RE FOOT�GE INVOLVED CONTACT PERSON ANO PHONE NO <br /> ��/lX-Q ��C. `U ) ]l� /�-P- ` �(/�✓ <br /> �, uR- �—L�YL_ �JCL.e�IS I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> aaoroseo E O�BUI�f1ING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> — S /.•f iZC � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDES RIPTIUNOFPROPcRT`�ISMOWNBELOWORATTFCNiWOCOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DO=S NOT PRESUME TO GIVE <br /> �.or e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> -- PERFOR�IANCE 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 /> anRce�Tna i o Nun�eer+ CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTRUCTIOHLOANLEN�ER.�OORE55 TELEPHONE NU6�'�ER � <br /> r <br /> PROJECT RESS �� scr�� wc o+tt // �'� <br /> �J�J ��C ,( ° cnvaosi�ussircus rvo � <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FU(TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIF SYSTEMS-6.T.U. tA E.A. <br /> LAVATORY�WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRVEFS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE tWOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSEFT <br /> F100H DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS ExHAUST FAN ' <br /> SINK(SERVICE—BAfi.ETCJ <br /> SUB TOTAL 5 SUB TOTAL S <br /> PERMIT 5 PERMIT S <br /> TOtAL FEE S TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> GRONTSETBALK REAPSEiBAGN SIDESETBACN PUNCHECKNU6�BER FEE AECEIPTNO <br /> -yyi 7 <br /> usezoNe ioraeen VFCANiSRE FEES VALUATION FEE <br /> �. YES . NO �UIL�ING �j �(�O <br /> iYPE Of CONSi NO OF S70RiE5 xC.:�•.0 .�o'rvnnw,6 ur:ns - <br /> c�c�.,r pLUM81NG i <br /> SIZEOFBLDf FlPESPqINKLERSRCOD BASEMEIR ��ECHANICAL <br /> "-� YES �. . NO <br /> OCCUPANCYLOAU FIPEALARI.IREOD NEIGHTLIAIITATION ADDITIONALPLANCHECK i <br /> � <br /> OTNER <br /> R[ASON � <br /> STATE BUILDING SURCHARGE � <br /> iN1AHE PV PLANSAPPROVF.09V CITY OF EVERETT PU�LIC WORKS <br /> LOCALSALES <br /> oniE TAX CODE IS 3705 TOTAL <br />