Laserfiche WebLink
� � <br />APPLICATIO./ FOR CONSTRUC'�T.JN PERMIT everett <br />MeEve'grcen TO BE COMPLETED IN INK—PLEASE PRINT � <br />CITV OP <br />everett HEATING SYSTEM: ❑ GAS ❑ EIECTRIC ❑ E'�A/�/NL� if[ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILUiNG : MECHANICAL PLUMBING SIGN <br />OWNE�� � MA�E55 �u� 1�7� ���oT p�p� ��� <br />J <br />TENANi MAILAODRESS GITY 21P PHONE <br />DESIGNER <br />GENEPALCONTRACTOR <br />�!`l�QEN�arr4L /U,(p�7j�— <br />MAIL ADDRE55 dTY <br />PHONE <br />�/S.T=22Y� <br />PNONE LICENSEr <br />MEGMANICALGONTFACTOR MAILADORESS CITV ZIP PMONE UCENSE• <br />CONTRACTOR M�ILA��RE55 <br />Kfr�a�.v.�/ � <br />CUSS OF WORK <br />7C NEW � � � ADDITION <br />I CONTRAGT PRIGE OF WOFK <br />DESCRIBE WORK AN� S�UARE <br />LEGAL �DE(SRCRIPTION OF PROPF <br />LOT f �+ BLOCN <br />fs�/ /) <br />�clE�2 <br />aaaecr <br />WATER CLOSET <br />BATHTUB <br />LAVATORYIWAS <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />cirv <br />PMONE LICENSE • <br />ALTERATION I� REPAIR .' DEMOLITION .� WOODSTOVE/FRPL INSERT i. . BUILDING RELOCATION <br />0o CONTA RSONANDPNON� <br />�CO — �lAGO ICE7cHeR/� - 2�J' -SZJ7/ <br />BACKFLOW FREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR. ETC <br />I HEFEBY CERTIFV THAT I HAVE READ AN� EXAMINED THIS <br />� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LOW ORATTACM FOUR COPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR <br />oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />',, � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />.� (%C� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />r�A OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 27 RCW AND 296.200 WAC. <br />SIGN EOFC TRqCT R HAUTHORREDAGENT DATE �p y-yd <br />X �- P,�,� �o t,�,,� i�� <br />nc 2 <br />APPLICANTS CITV BUSMESS LICENSE NO. AND �USINE55 NAM <br />MECHANICAL <br />OR ITEM I FEE <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REARSETBACK <br />USEZONE I LOi <br />SUB TOTAL 5 <br />PCSMIT S <br />SI�E SETOACN <br />VACANT SIiE <br />iVPEOfLONiS.ALIOWABLE iVPEOfCONSi.ACiVAI OCCuveN[v NOWOw[IUNGN�ns <br />aAouP <br />S12E OF BLDG. NO.OF STORIES BASEMENT <br />OLCUPPNCYLOAD FIRESPRNNLERSREQ'D HEIGMTUMITAiION <br />INiAKEBY I PLANSAPPROVEDBY I CITYOFEYERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />A1C—lUHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />VENTIIATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNE'I <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUSTFAN <br />FEE <br />SUB TOTAL $ � <br />PERMIT $ <br />TOTAL FEE $ � <br />NUMBEF � FEE � RECEIPTNO. <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONFL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />•I• <br />� <br />