Laserfiche WebLink
APPLICATIOK :OR CONSTRUCTIC� PERMIT <br /> TO BE COMPLETED IN BLACK.INK—PLEASE PRINL � <br /> BUILDING DEPART��IENT HEA7ING SYSTEM: GAS ❑ELECTRIC �,�/S�fi17 <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING_�,ECHANICAL PIUMBING SIGN <br /> pWNEfi M4ILADORESS CITV 21P PHONE <br /> f�inur raa�u�F l�o,�rm�. 9iCo �-��� l;d� _F,;- �.1g l8zo/ C2�) ZSB- Z!2 <br /> TEIUNi Y M��L ADDRE55 pTY ZIP PHpNE <br /> �L <br /> ARGH17ECTOHDESIGNER MAILFUDRESS �._.�i�� Cliv ZIP /� PNO <br /> 6��ar+ � �l�tiKc.- �G1�G �vi ^yr�G �E�:r,L�4. ��?1Y ( ZQ�v zJ�8� <br /> GENENALCONTR�CTOR MRIL�Pp qE55 � CITY 21P PNONE STATEUCENSE• <br /> L1E.-�c.4,va �� tsrar 4�9 /.=v�rU�i�. <br /> MF:CNANICAL CONTR�CTO� M MR AODRES GTY 21P PHONE SiATE LICENSE I <br /> ,���J � ,�,7Y��� ,��8 ,(��rnx✓fr,w L�, 98z27�-Te4,� <br /> PLUMBING�TOR MAILADDRP$5 CITV 21P PHONE �A�ICE�C� <br /> CLFSS OF WORK � <br /> _ . NEW � ADDITION � ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PF.RSON AVD PHONE N0. <br /> CONTRAG PRICE OF WOqN <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> PPOPOSEDUSEOfBUILDING I HEREBY CERTIFV TfiAT 1 HAVE FEAD AND EXAMINED THIS <br /> APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�L DESCRIPTIONOF PROPEHiV(SHOWN BELOW OP RTTACM FOI/RCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot e�ocK oF NOt THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLAT[ OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. 7HAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 296.200 WAC. <br /> x/-/ o.u.� � ( hK�,�d.,7� 4 Z�-f� <br /> PROJECT RUURESS Sicnnru4[ � � � D�7����� <br /> cnv eusmrss ucrese Ho <br /> PLUMSING MECHANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FEE NO. TYPE OF EQUIPMENT �E <br /> WATEF CLOSET(TOILET) � AiC—AiHNDLG UNITS—H.P. 7 , <br /> BATHTUB _ ; FORrED AIR SVSTEMS—B.T.U. M E.A. <br /> —� <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAV ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIqEPLACE INSERT ' <br /> � <br /> FLOOR DRAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—fiAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> O (�,O�R. <br /> SUB TOTAL $ SUB TOTAL $ <br /> PFRMIT $ PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETARCK REAR SETBACN SIDE SETBACK P N NUMBER FEE RECEIPT NO. <br /> USE ZONE LOT qRER VAGqNi SITE FEES VALUATION FEE <br /> �UILDING ' <br /> TVPC Of CONB.RLLOWABLE TYPE Of COH51.ARUAL aCtuc�x[r No a oWhuuG uNns <br /> cnouo � PLUMBU�G � <br /> SIZEOFBLOG. NOOFeTORIES BASEMENT MECHANICAL <br /> OCCUPANCY lOAO FlRE SPRNNLERS REO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECN � <br /> SPRINKLER i <br /> REASON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> MTANEBY PL SAPPROVEDBV CITYOFEVERETT PUBLICWORHS <br /> / LOCIIL SALES <br /> TAl(CODE IS 3105 ror�� ; <br /> �� , <br />