Laserfiche WebLink
APPLICATI4.� FOR CONSTRUC1�aN PERMIT <br />Tn RF COMPI FTFA IN INK—PI FASF :�RINT <br />.e,d�w„ <br />CITV OF <br />everett <br />BUILDING DEPAR'iMENT <br />259-8810 <br />HEATING SYSTEM: J�GAS ❑ ELECTRIC U <br />---. <br />everett <br />e <br />f"! DEMOLITION I i COMBINATION I 1 BUILDING I 1 I:�IECHANICAL L] PLUMBING ` I SIGN <br />OWNEfl M�IL ADDRESS CITV ZIP PHONE <br />/%1 //�f� Of1'///S �i9 3 8 �VR�E'L3ECK A2�E. � U�A'ETT� GUf�. �%S�es3 �`3 �� — 'j"J�l/ <br />TEN�NT MAIL �U RESS CITY ZIP PHONE <br />ARCHITECTOROESIGNER MRILADDRE55 CITY 21P PHONE <br />'o�i,�x�_Z� �cs. .�8�� � �� ��v��r , g.�,,� �a.sa- �ir L <br />GENERQCONTP�CTOR MAILA�DPE55 C V _ ZIF PHON LICENSE� <br />.Uar ��Ce�� - 7D �3c: SiD /��1rn �'- �F�125 �(% <br />MECHANICAL CONTRACTOR MAIL ADOAESS CIT ,_ �, „ jIP _ P40NE , __ LICENSE / <br />GLUMBINGCONTHACTOR MAIL <br />CITY <br />I <br />NEW C! ADDITION I 1 ALTERATION I I qEPAIR f_ 1 L�EMOUTION I 1 WOODSTOVEIFRPL INSErIT ��i 0I11LDING R@COCATION <br />� �/ ,/ CO^NT'�GT PpEF1SION ANO PHONE NGO. <br />rto�cr omro nc wnaK /)/iSFG� ��O �f V%� ,v� � [ I� V� J Na M F =1 � 3 I <br />AND SWIIRC FOO7AGE INVOLVEO <br />PROPOSED USEOF B111�DING <br />��E��� � <br />LEGAI DESCRIPTION OF PROPERTY �SIqWN BELOW OR ATTACH FOUR COPIES� <br />LOT � BLOGK OF T.('/.n DA <br />aRwccc �oeness <br />�� <br />'_� <br />PLUMBINO <br />NO.T— 1 'E OF <br />LAVATORY (WASH BASIN) <br />SHOWER I <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY � <br />CLOTHES WASHER / <br />UFINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ETC <br />FOR OFFICE USE ONLY: <br />FRONTSET&�CN REARSET <br />USE ZON�r LO� REA <br />_S �3c <br />ttPE Of LONTS. �LLOWABIF ttPE Of C01 <br />3� t5 SF t No. oi <br />9 SF A�C <br />OCCUPANCY LORD FIRE 5 <br />RERSON FOR SPRINNLEPS <br />INTAKE BY PI.ANS <br />OR <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />SIDE SETBRGK <br />1F <br />r►1�c ?.S � <br />VACANTSIIE <br />�� v <br />ist. ectuai <br />r, � <br />)RIES <br />�ERSREO'D <br />�� 3 <br />ROVED BY <br />I �C <br />'! /99' <br />W��l! �55-9��i� <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PFOVISIONS OF LAWS .4ND ORDINANCES GOVERNING THIS TYFE OF <br />WORK WILL BE COMPLETED WITH W4ETHER SPECIFIEO HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFi THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PqOPERTY TO PERFORM THE WORK POR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />SIGN�TUREOFCON�RACTOROR�UTHORIZEDAGENT OATE <br />X GL�LG�j�J�IX"' Z�G'I� '� � �5'� <br />� <br />•PPLIC�NTS CITY BUSINESS LICENSE NO. ANO BUSINESS YRME <br />MECHANICAL <br />VO. TYPE OF EOUIPMENT FEE <br />FORCED AIR SYSTEMS—B <br />UNIT HEATEHS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />HANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMi <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />/ BUIIDING <br />OLCUPeNtt NOqDW[LLINGIMrtS '— <br />cnouv ' pLUMBING <br />BASEME`IT A7ECHANICAL <br />Y�--s <br />HEIGHTLiIAttniION AODITIONALPLANCHECK <br />Z S � OTHER <br />STATE HUILDING SURCIiARGE <br />CITY OF EVERETT rusucwoHKs <br />LOCALSALES <br />TAJf CODE IS 3105 TOTIIL <br />SUB TOTAL S <br />PERMIT b <br />TOTAL FEE 3 <br />J �c.:J =� <br />C <br />d <br />