Laserfiche WebLink
....._..�.....��. <br /> _ , <br /> APPLICATIC"1 FOR CONSTRUCT'°°�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYc,TEM: ❑GAS ❑ELEI:TRIC � N /1 <br /> 259-8810 <br /> ' I DEMOLITION I COMBINATION ��UILDING i i MECHANICAL i i PLUMBING I ! SIGN <br /> O1YNEq MAI�AODRESS CITY <br /> 3�.vNwrt4ii Lm, ziP rHoi�e <br /> p_,Z�,c��. l Fb 3o x �I o '}- E.U�Xt�TT 9f32�G �•�o -sba -9rv� <br /> TENANi r MMLApDRESS CRY ZIP PIIONE <br /> �L <br /> ARCNITECTOROESIGNEfi A'AILADDRESS CITV .'IP PNONE <br /> ' GENEPALWNTRACTOR 1.141LADDRESS Gs7Y,'' n•'.I 21P PHCNF. STAT.E�IIpCENSEd <br /> IA[CMANI��L C'O Rr1C��r��A`k�'�5~� '�oc�oJr3G86 qT�f/� ZIP�A3��HONE y��T�TE'L CEN������ <br /> .c/�.t <br /> PWh1BING ONiRACTOR M�ILAODRESS CITV 21P PHONE Si4TELICENSEe <br /> C(yJTFACT PRICE OF 1VORN � <br /> �� v - <br /> DESCRIBE WOPK AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PNONE NO <br /> 8 T. d — L✓b.! . <br /> ' � ''S 'fr�"ti H K YA1L+� — 4 SS•TS!b <br /> °� N• w� si o✓ - �Pcn•sv.v•9�y <br /> I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br /> PROPOSEOUSEOFOUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. �LL <br /> �SA7iac�-bf�{i _CA✓l�oL (� , U.U'�d.M�g PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCRIPTIONOFPROPERTV�SHOWNBEIOW rncH YOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior o�oc!c aF _ NOT. THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE <br /> ` AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _�,sLL� AYT1ICJfLl� J OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> � vaace�Tnxi.o.nun�eEa APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> O BoZ�I�S ^ �")^ DO,$ — 000 3 CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTFlUCTIONLOANLENOER.ADDRESS.TELEPHONE NUMOER <br /> .v/� / .h <br /> PRO�J/E,CT AD�/R�E'SS �/�] .I �/ /(,/ (n� �''/1 s�c•,n.une�" �S�,G 3�-3SG.4�� y <br /> t/LL// �V/%/r�NK�U� /��K/ 0'l. �j��/•W� .�rrnusw[SSlicinsrh� � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � q/C—AiHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYST[MS—B.T.U. M E.A. <br /> LAVATORY(WASH BASI � UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS , <br /> KITCfiEN SINK 8 P VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYT Y WATFR HEATER � <br /> C THE ASHER � WOOD STOVE <br /> . A ; METAL FIREPLACE(WOOD BURNING) <br /> RI ING FOUNTAIN FIREPLACE INSERT <br /> F OR DRAIN � HEAT PUMP <br /> ACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ; <br /> SINK(SERVICE—BqR,ET4) � <br /> � <br /> � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL 5 <br /> PEFMIT S pERMIT 5 <br /> TOTAL FEE 5 ; TOTA�FEE S � <br /> FOR OFFICE USE ONLY: � / �U� • ��„��• _ �� <br /> FRONTSETDAGK RE�RSETBFCK 510ESEiBACK PLANCHECKNUAIBER FEE � RECEIPiNO. <br /> �1G-(v� /`�!�-J5 <br /> usezor+e LOTAREF VACANTSITE FEES VALUATrION FEE <br /> ''. ��. YES ,... NO BUILDING Y��3 b -K �j ' i� <br /> 1YPEOfLONSI NO.OFSTORIES o[[u�a•;tr r;0oro's[WAGUM6 <br /> ^ / / GaOu� � <br /> � — /�i g_� PLUMBING i <br /> ZEOFOLDG. FIRESPflINNLERSREO'0 BASEMENT h1ECHANICAI <br /> /v� `-� YES / <br /> UPANCYLOAD FlREALARMREOD NEIGMTLIMIIDTION ADDITIONALPLANCHECK � <br /> i <br /> u OTHER i <br /> REASON <br /> �— <br /> STATE BUILDING SURCHARG[ � `�� <br /> INiANEBV PL�NSAPP yEOOV CITY OF EVERETT PUBLIC WORKS <br /> / qr� LOCAL SALES <br /> onre �' /� � TAX CODE IS 31U5 TOTAL \ ��\;- <br /> V <br />