Laserfiche WebLink
APPLICATI�,N FO�i CONSTRUC'� iON PERMIT <br /> everett <br /> tho E�crgrern � <br /> CI7Y OF <br /> everett <br /> BUILDING DEPARTMENT <br /> �3 cr� �+ 259-8810 <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> � t� DEMOLITION COMBINATION xBUILDING MECHANICAL PLUMBING SIGN <br /> � y O\YN[R MAR ADDRES i �—QTV �lf� i��pONE C� ^ �- <br /> � y c~i, �1�ti1 ERA��r-�P. �� �C���C— � . '`.��I ( ) -� ��=C i 7`���� � 'C� < <-�i_ I <br /> jEr;.N1 AMAIILR�OfiESS �ry, �. arv iir � VHONE <br /> H� h�-� ���_� C I �h7rt'� <br /> K y� nvvOlrt1—[CTOROESiGHGP IA�RADDRE55 Cltt ZIP PMONE <br /> '� H ytl F�.1— t— � L�l�1L.i�—.�z4�.—�3i73n 5���.� .�.�—�f 10I (' a�L.'C�� �� <br /> N p.� GEN4F�lCONTq�CTOB MAILADDRE55 CIiV I 2ia PHONE IiCENSE♦ <br /> y�n �_ �����,_ <br /> t'J O � A' CH4NiCALLCNTRlCiOR AIAtLADDHESS CITY 21P PNONE LICENSFt <br /> HC <br /> N � Y PLUk,BINGCONiRACTOR AIAP.AU�RESS QTY ZIP PHONE LICENSEx <br /> V <br /> 4]Y �] <br /> H — —_ — <br /> �y� ClRS50F\YOfiN <br /> ,�,�, H y NEW � ADDITION � - ALTEFATION REPAIR . DEMOLITION . WOGJSTOVE/FRPL IiJSERT BUILDING RELOCATION <br /> �J `iENAM IM1IPROVEMENi OR INCfRIOR RERIODEL ONLY / yyy777 11 p U CONIDCT{,PE�RSON nANDA PM^ONE N1�� � // //� <br /> O �� `LONTRACTPRiCEOF'NOflK: �r:� � I f�\ I Y'V� � 1� I` �C?�— ��`-"� <br /> OE`CRI�E WOPK RNO SOUPPE FOOLAGE INVOWED <br /> �� � "� � �S — �—��, � �US . <br /> z y y PROPOS[DUSEOFOUILDMG I HEREBV CERTIFY THAT I HAVE READ AND EaA?AINED THIS <br /> H O CA ��'���� ���IC�S APPLICATION AND KNOW THE SAME TO Bc TRUE AqD COF"ECT.ALL <br /> IF.GALDESCRiPTIONOFPROPERTV�SNOWNOELOWOR�ifACHFOURCOPiES� PROVISIUNS OF LAWS AND ORDINANCES GOVERNING THIo i�'OE OF <br /> WORK WILL BE COMPLETEC WITH WNETHER SPECIFIED HEREIN OR <br /> wt etocK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AhV <br /> OTHEF STATE OR LOCAL LAW REGULATWG CONSTRUCTION OR THE <br /> — PERFORIdANCE OF CONSTPUCTION.THAT 1 AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLIChTION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> s:c�NtuR[oPco4iancionoRAun�orb:[onG[NT oArL <br /> —.�--��-`�_��c� X <br /> anaFCT non�s <br /> 3� ��� _LL� �PfLIC�NiSCITY0U51NL55LICLNSENOPN�fU5:NE55tlAI}E <br /> i���. PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> i WATER CLOSET(TOILET) !vC—NHN�LG UNITS—H.P. <br /> �� , BATHTUB FORCED AIR SVSTEMS—B.T.U. M1i E.A. <br /> � LAVATORYINASHBASW) UNITH[ATEFiS—B.T.J. M <br /> I� 1 SHOWER CLOTHESDRVERS _ <br /> � KITCfiEN SINK 3 DISP VENTILATION FAN <br /> DIShIW�SHER RANGE HOOD <br /> LAUNDRVTRAV WATER HEATER <br /> � i CLOTHES WASHER WOODSTOVE <br /> I _� URINAL METAL FIREPI.ACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE 11dSERT � <br /> —� <br /> FLOOR DRAIN HEAT PUMP <br /> � BACKFLOW PREVENTERS ; GAS PIPWG <br /> 1�1�' ROOF DRAINS--RAINLEA�ERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> '� <br /> �_ � <br /> —� <br /> � SUB 70TAL S SUB TOTAL S <br /> �' _ PEFMIT 5 —�—_ PERMIT 5 � <br /> +'�� TOTAL FEE S TOTAL FEE 5 � <br /> �pn;iiSETOACK RFRPSETOACK SIfJ[SEiBACN PIANCfECNNl1M(lER PEF =[�, BECE��PiNO{�� <br /> � )�� "� �L� �� Lti--AJ <br /> us�zoN[ IOTAREA vnCnr�tsne FEES VALUATION FEE <br /> . YES O DUILDING � �-� � � � �'���� �� � �� ' <br /> 11v!Of CONSi AILOWABLE IYPE OV LONSI ALNA� �y�.r�v[r xo m Pnu�'.::�,•.', —1�--1—�—� � L--L=... <br /> �_ � �_z � PLUTA�ING �� <br /> SiZf.OFB�IX'..S��G NOOPSTQIiIBS OnSEMENt h1[CNANICAL <br /> ' Fj / . YES � NO -- <br /> OCCUPANCYIORD FiBESPFNKL[RSR60D HEiGMTLiMrtpTiOY OTHER <br /> � XYES NO STATE BUILDING SURCHMGE ���r� <br /> i�[n50N FOR SPRINNlEPS — -� <br /> STATEENEPGYSURCHARGE <br /> APPiiCAtIONRCCBY �'LAI�S/PPPOVF.U�� CITYOFEVERE7T PU�LICWORK$ <br /> / � <br /> j 7' LOCAL SALES <br /> � �-C_ TAX COUE IS 3105 tora� 1 '� i 7' <br />