Laserfiche WebLink
APPLICATIC�1 FOR CONSTRUCT 1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM J GAS ]ELECTFiIC J � <br /> 6UILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATlON BUILDING �CMECHANICAL PLUMBING SIGN <br /> OWN tdAIL�DDR[SS CITV ZIP PnON[ <br /> �coJ`fts N �%1`it ;� o�,_- a2�'i 3.� �!�/�� f v� i,�/,� ' 9t�.�d/ <br /> IENANT MNLADDRLSS GiY ZIP PNONE <br /> S�}'�S� <br /> ARCHIiECTOR�ESIGNER MML��OFESS GTV ZIP PNONE <br /> GENERALCONTRFCTOP MAII�DORE55 CITV ZIP PIIONE ST�7ELICENSEe <br /> MECHANIC�LGONTRACTOR MAILqDDflESS CITY 21P PMONE STATEUCENSE• <br /> �lnaLr� S`'E..Zv�.�.,� _I..Uc i? // `�` /� t•.• S�; ,�v. lviv• >�,�r� 3 S��! Q) !' <br /> ^LUM�INGCONTRACIOP MAIL�DDR[SS ���T� ZiP PNONE ST�TELICENSE <br /> M� C�is�/o/✓P <br /> CONTRAGTPRIG[OFWORN nv �� ��� �'S <br /> �� o�� — -- /� — <br /> DESCRIBE WGRN AND SOUARE FOOTAGE INVOLV[0 CONiACT PERSON ANO PHONE NO �C j,�lF �G�J�L/` _ <br /> �� <br /> ��.e�- .S yS f.:.n .l+v �1 fc/��.+ S � S / �' S $ _ <br /> �Td�IJ - I'I�Puc.Q I HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br /> PROPOSED US[OF Bl1ILDiNG APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> ie�n�oescaiPnor+oFPRoaearv�sNo��r+ee�owoanrmcnnvocoPiEsi WOP... WILL BE COMPLETED WITH IYHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES �OT PRESUME TO GIVE <br /> ioT 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 AUTHORRED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> annce�rnx i o.�..,..��,• CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTFUCTIONLJANLEN�ER.AOORESS.TELEPNONENOIAOFR �� / / /� � �r/� <br /> X <br /> %r� �J � <br /> PROJECT ADDRESS s�cr+sim�r °"'� <br /> Q �,� v• /�} — ��+/ ciivnus�urssi��E�+sc rvo <br /> PLUM ING MECHANICAL <br /> NO. TYPE OF F�STURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(T,�ILET) � A�C—A�HNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. �— <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M _T_ <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP � VENTILATION FAN <br /> DISHWASHER RANGE HOOD ' <br /> LAUNDRY TRAY WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOF ORAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> FOOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> SUB TOTAL .`� SUB TOTAL 5 <br /> PERMIT 5 PERMIT $ <br /> TOTALFEE 5 ' TOTALFEE 3 <br /> FOR OFFICE USE ONLY. <br /> FEE PECEIPT N0. <br /> FPONTSETD�CK REAFSETBACN $IDESE7�AGN PLANCM`I NOMO[R Q�`I� <br /> USE20NE LOT�REA <br /> VACFNT SITE FEES VALUATION FEE <br /> . VES � N� pU1LDING � <br /> 7VPEOFCONSI NOAFSTORIES oai.��utv eOMmauu�.;eii:5 � <br /> eacur p�UMBING _ <br /> i <br /> 512EOPBLDG. FIR[SPRINKLEFSFEO-D D�SEMENT MECHFNICAI <br /> :— YES NO <br /> OCGUPANCYLOAD FIREALARMRE00 HEIGHiLIMITAT10N <br /> ADDITIONAL PLAN CHCCN � <br /> OTHER F. � � ����� <br /> � 1� \ 1\\��`V' +� <br /> r— — <br /> ilEA50N <br /> STATE BUILDING SURCHARGE <br /> INTANG BV PLANS�PPROVED BY CITY OF EVERETT PUBLIC WORKS � <br /> �N1 LOCAL SALES <br /> onTE � �J `, <br /> TAX CODE IS 3105 70TAL �`�", �y�zH CS�IS� <br />