Laserfiche WebLink
APPLICATI .. FOR CONSTRUC7�N PERMIT everett <br /> m,E,�y,e�„ TO BE WMPLETED IN INK—PLEASE PRNtT � <br /> atr oF <br /> everett HEATING SYSTEM: ,[j GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING 'I�AECHANICAL PLUMBING SIGN <br /> ON7/ER /�� 9 MAIL�DDRESS CIT' � ZIP PHONE <br /> � � . Nf-��L/ fl (l� 1„ -' '� � �f�- •-1 � ! ,�c iF i-; �,/� <br /> TEN/��N�T M�ILADDRESS CITV Z�F FNONE <br /> k',(� Li� S�o f:f � �- }.. ' �-'� ii,"��� /- �tt c �r „/A r �-.'� ^ �O -' =� <br /> �RGNITECTOROESIGNEP. MAILIIDDRE55 CITY ZIP PNONE � — - / ' el�.l�I' <br /> ii� ,�� . .77(:L '/Jl 0 '_ .•�%` � �, � � <br /> GENERILLCONTRAGiOR M�IL AODRESS LITY 21P ��..Pl10� LICENSE� <br /> i ,r`�� <br /> Ei.tiiFT1 `"�f ;7,G :4C 170 . P� o� ' - Fccl.c%� v�' c•��i_ F_-,: ��_I oF <br /> MECHNIIGAL CONTR�CTpq MAIL�DDRE55 CITY Z1P F1U]NE LICENSE� <br /> PLUMBMGGONiR�CTOR MRIL�D�RESS Cliv ZIP PlIONE IICENSE� <br /> GA55 0F VIOfiK <br /> ��. �. NEW [. �. ADDITION x ALTERATION .-�. REPAIR � DEMOLITION .. WOODSTOVE/FRPL INSERT G BUILDING RELOCATION <br /> �7,// � CANTACT PERSON/�ND PNONE NO. <br /> caHrn�cr vn�ce oF waM �/il/� �� .i iU ���-1/.¢;i�/ c] r-� � ��� �/ <br /> DESCR9 WOnINf/AJNO SIXI�RE FOOT�GE INVOLVEO � <br /> T/ � <br /> rnoroseouseoFeuaomc I HEHEBY CERTIFY THAT I HAVE READ AND E7CAMIHEO THIS <br /> ��� , l` . APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEML OESCRIPTpN OF PROPERT'ISMOWN BELOW OF ATi�GH FWR COPIES) PROVISIONS OF UWS AND ORDIN�NCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETMER SPECIFIED HEREIN OR <br /> �or eiocu oF NOT. THE GRAN1'ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TME PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL UW RE6ULATING CONSTRUCTION OA TNE <br /> PERFORMANCE OF CONSTRUCTION.THl1T 1 AM AUTMORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITN THE STATE <br /> � CONTHACTORS lAW 1E27 RCW AND 296.200 WAC. <br /> t <br /> , SIGNATURE OF CONTRACTqi OR 11UTNORIZED 110ENT DATE n. , /-S/ <br /> 7 ,-,, <br /> � X �t ��/ . , ,� � � _ <br /> � ��. SS ���- � �ii .� �.--•, , <br /> , �/ � �PPLIGINTSCITYBUSINESSIICENSENO.IJ/O8U5ME55N11ME <br /> . K��p �IEGIANIC�I <br /> N0. TYrE OF FlIITURE OII fTEM fEE N0. 7�'rE OF EOIM�MENT FEE <br /> WATER CLOSET(TOILET) NC—AMNDI(i UNITS—H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LIWATORV(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> gMOyyEq CLOTHES DRYERS <br /> KI?CMEN SINK 6 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE F100D <br /> UUNDNY TRAV ; WATER HEATER <br /> CLO?HES WASMER � WOOD STOVE �_ <br /> URMIIL ' METAL FIREPLACE 6 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN _ HEAT PUMP ' <br /> BIICKFLOW PREVENTERS ; CaAS PIPING I _ <br /> ROOF DRAINS--RAINIEADERS � EXHAUST FAN <br /> SINK(SERVICE--BAR,ETC.) � <br /> � <br /> � <br /> SUB TOTAL E SUB TOTAL S ' — <br /> PERMIT S PERMIT S - <br /> TOTAL FEF S TOTAL FEE $ � <br /> fOR OFFlCE USE ONLY: <br /> PRONT SETB�CN AE0.q SETBACN SIOE SETB�CN PLAN CHECN NUMAER FSE RECEIFT NO <br /> �7Ct'3 <br /> USE 20NE LOT nRER V�CANT SRE FEES VALUATION FEE T <br /> BUILDING ' <br /> — i— <br /> TVPE Of COXfS.MIOW�BLE iVFE Of CON51 PCTURL xcw�xCr No a bMuiNGUNr.S � <br /> ''"W° PLUMBING <br /> i� <br /> g�g pF g�pC,. ra oF S7oRiE5 BASEMENT MECHANIGIL <br /> OCCUPRNCV LA�D FlPE SPRNKLERS REO'D NE�QHT LIMIiF71pN pDDITIONRL PUN CHECK i <br /> i <br /> OTNFR � <br /> RE�SJN FOP SPPINKLERS <br /> STIITE BUILDING SURCHARGE <br /> _ <br /> MTAKE BY PUNS�PPROVED BV CITr OF EYERETT PUBLIC WORKS <br /> � LOC11L tALEB <br /> TAX CODE IR�105 fOT�L J �rj' <br />