Laserfiche WebLink
Q�PPLICATION FOR CONS�RUCTION PERIV�IT <br /> everett <br /> Iha E�roM.reen � . <br /> CI7V OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PI.EF,SE PRINT , <br /> , 259-8810 <br /> ❑ DEMOLITION C] COMBINATION I_1 BUILDING I IMECHANICAL �(PLUMBING ❑ SIGN � <br /> �NE1TV� M`��/.VRE55 '�`-�=� OR AOW�IW�� NION1j�_�� �_ � <br /> TEN�NT MAIL�DDRE55 GLY 21P PHONE � <br /> �9CIIIlECTOR0E51GNER M�IL�OOBESS CItY 21P PIIONE <br /> y O�-+ <br /> r� GENERALCOMAACTOR MPR�UOR[SS LiIY ZiP PIIOLE UCENSE• <br /> �;y �crr►a�� �/OrrtES �37�5 �3 ow�4 �n�Hc�mcsF�►�OY,�cN i�qcp <br /> s <br /> Q.b.Y+ M[CH�NiC LCOMIUGTOR AUIL�O�f1E55 CItY 21P PHON[ UCENSE� <br /> ay� <br /> vwuoir+acoNmnaon ueanoonEss cirv zm rnor�r: uceuse. <br /> � �H TJF�S'l�4Ct 't�.�mQ�N� <br /> � y� anss oF wonK <br /> � H� XNEW L ADDITION ❑ AL7ERATION I_7 REPAIR ❑ DEMOLITION I] WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> yC/�� tEN�NTIMPROVEMENTOPINIERIORREMODELONLY COI+M.GTPEn50f1ANDPNONENO. <br /> .T� x� CONiR�CT PfiIGE OF WONN: <br /> C� Q DESLPIOEWOPN�ND5004PEFOOtAGEINVOlVEO <br /> �d i n <br /> � �g P�u �4, ,.(P.�- I �.� 1 _ x <br /> rnor SEOUS[OFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Hv Oq �.���`-� . � ��` APPLICATION AND NNOW THE SAME TO BE TPUE AND CORRECT.ALL <br /> Z y 3 �ecn�oes nirtioNOFrnorenrvis��owHoe�owonnrinu�rouncovics� PROVISIONS OF LAWS AN�OfiDINANCES GOVERNING THIS TYPE OF <br /> ti� �J WORK WILL DE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR <br /> x tot�:�-7 e�ocK o NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> y�7 AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �,.i '��. OTHER STATE OR LCCAL LAW REGULATING CONSTRUCTION OF THE <br /> n d y PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � �"� OWNER OF THIS PROPERTY TO PERFORM THE WORY, FOR WHIC4 <br /> �PPLICATION IS M��E AND I COMPLY WITH THE :.lATE <br /> Z H CA CONTRACTORS LAW 18.27 RCW AND 2962C0 WAC. <br /> HOfA sic� neovcor+�nncrononnuiHonizeoncer+r onre <br /> G <br /> PRW ECT ADORESS <br /> ��r p APPLIGR iSCIT" U5IESSUCENSENO./•��OOUSINESSNAME <br /> � \� • <br /> PLUM6ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � � WATER CLOSET(TOILET) �( � NC—A/HNDLG UNITS—H.P. � <br /> �' ! BATHTUB FORCED Alq SVSTEMS—B.T.U. M E.A. ' _ <br /> LAVATORY(WASH�ASIN) �{ '1 UNIT HEATERS—B.T,U. M � <br /> '� ..�' SHOWER � ' � CLOTHES DRYERS —T— <br /> KITCHEN SINK 8 DISP �b'L� �', VENTILATION FAN _ �_ <br /> ` DISHWASHER � i{ RANGE HOOD <br /> LAUNDiIYTRAV � WATERHEATER i_ <br /> '� � CLOTHES WASHER � WOOD STOVE � <br /> ! URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT _�_ <br /> � FLOOR DRAIN i HEAT PUMP <br /> �' � BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAIIJLEADERS —�— EXHAUST FAN <br /> SINK(SERVIC[BAR,ETC.) <br /> �. � — --� <br /> � � <br /> i --� <br /> _ i <br /> ,,,�I� SUB TOTAL $ <br /> � SUBTOTAL $ ; ;(' ���'fl-- <br /> PERMIT $ —r PERMIT S � � <br /> TOTALFEE $ C( 10TALFEE S _ <br /> . " fRONi5Et0ACN �EMiSETBRGK St0E5E10ACN �IANCN[CNNUA10Ef1 f[E RECEIPtNO. <br /> usEzoNe LMARE� VAC�NTSItE FEES VALUATION FEE <br /> I:l YES U NO OWL�ING � <br /> IYPEOfLO�l9.ALlOWABIE fYPE0iG01151.AC1UPL ���'Kv xOaoMuix4moi3 Q <br /> cnc�r PWMBING Q � � � <br /> S12EOFOlDG. NO.OfSiOfll[5 O�SEM[NT MECIIANICAL I ry_l� <br /> I.1 YES 1_I NO � <br /> OCCUP4NCYlOAD FIRESPRNNlERSB[00 11[IGIIfLIFU1AilON OTf1EP _ <br /> ❑ VES CI NO STATE DUILDING SURCHAtiGE <br /> ---i— <br /> nensoNronsrnwkiens � <br /> STAIEENERGYSUflCHARGE <br /> — <br /> �PPlICR110NRCC.OY Pinr+snrrnoveoor CITYOFEVERETT PUDLICWORNS 1 <br /> LOCAL SALES �_��_ <br /> TAX COOEIS 3105 rorai <br /> --`i � <br />