Laserfiche WebLink
APPLICATION FOR CONSTRUCTION PERMIT <br /> me ewre�n everett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> CI DEMOLITION I:1 COMBINATION �BUILDING (7 MECHANICAL I I PLUMBING f_1 SIGN <br /> OWNER M�IL A�DRE55 p��Q ( ( m <br /> � ��12���—���Q����.f=s=`-1 citt7'� I � r � ir) �,_� F,��i 1 �'� rll� ��� j ���711���C;����CJ <br /> 7LNANi MAl1,ADflfif:55 CIIY 21P PIIONE <br /> ��-'��OJ�T1�.C, �P.F'� . , <br /> � APCNITECTORDESIGNER MRILAO�RE55 � CIfY 21P PII017E <br /> �I ��__l._U_2L1�'d(��,—dr`a3� s�'��/��RflLQI_(n �L-C��=61 <br /> GENER�LCONTRIICTOR MAII.ADDRESS I CIIY 21P �'110NE ) LILENSE� <br /> I �N /��ST. ,�„��� �It�+� ' n j;(�t ` �'�(i�l •��1- ) <br /> -�� /-JuF n� ���� . =�r.'�( <br /> MEGN/W:^.ALCONTRACTOR MAILA�ORESS diV ZIP PIIONE LICENSEI <br /> i <br /> ` i' (lr( d1 „" � ) ; <br /> PIUMBINOCON11v1CT0li M�ILAODfiESS CIIY 71P PIIONE IICENSE� <br /> CUSSOF WORN <br /> 1.7 NEW ❑ ADDITION ❑ ALTERATION I I REPAIR I_I DEMOLITION I I WOODSTOVE/FRPL INSEHT L.l BUILDING RELOCATION <br /> TEN�NTIMPROVEMENTOP�1.�EflIONPEMODELONLY ��..��� COtIfACiPE050NRNDPIIONEkO. <br /> �LONTP�CTPRICEOFWOI'K: �� ) 4� ��� �� ,� 2 ��2— � <br /> OESCRIBE WORK ANO bOW Ri�nOTA3�-INVOLVED <br /> `�"� �S— ��'� �—��r> — I <br /> PROPOSED USE OF BUILOINO -- � <br /> A I IIEREBY CE�'TIFY THAT I HA�•c flEAD 41v0 EXAMINED THIS <br /> ��ET�IC1h��F j'IG�s APPLICATION ANJ YNOW THF,iA�dE TO BE'.HUE AND CORRECL ALL <br /> LEOIILDESCRIPiIONOFI`ROPERTV�S'OPNBELOWORATGGIIFOfIRCOPIES� PROVISIONSOFLA�SANDORDIVANCE. ,iOVERNINOTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH`.":HETHER SPECIFIED HEREIN OR <br /> �ot e�:+cK __ oF N07. TI1E GRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE i <br /> AUTHORITY TO VIOLATE OR CANCEL THE PflOVI510NS OF ANY <br /> 0711ER STATE OR LOCAL LAW pEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIIEO BV THE <br /> OWNER OF THIS PROPERTV TO PERFOHM THE WOFK FOR "'41CH <br /> APPUCATION IS MADE AND I COMPLV WITH THE „ipTE <br /> __I ,�__ CON fRACTORS LAW 1827 RCW AND 296200 WAC. <br /> �'�� ��i sicNnimaeorcanimr,�ononnun�omzennaenr onie <br /> `��.��=�c,��(Z X <br /> PROJECT�OORE 5 <br /> �PPLICANTS CIIY OOSINESS LICCNSE NO.AN�BUSINE55 N�ME <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE Ofl ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> _ WATER CLOSET(TOILET) �_ _ NC—A/IINULG UNITS—N.P. i <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.I;. M E.A. —�— <br /> LAVATORY�Wl15H BASIN)__ --i UNIT HEATERS—B.T.U. M ; <br /> SHUWER � CLOTIIES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENiILAT10N FAN � <br /> DISHWASHER � RANGE HOOD —�— <br /> LAUNDRY TFAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE�� � <br /> — '-- - — <br /> URINAL � METAI.FIREPLACE 8 CHIMNEY ; <br /> DRINKING FOUNTAIN --} FIflEPLACE INSERT � <br /> FLOOR�RAIN � IIBAT PUMP —i— <br /> �— <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> F100F DRAINS—RAINLEADERS i EXI�I1IUST fl�N i <br /> 1 y <br /> SINK(SERVICE—BhR,ETC.) ; � <br /> --r— — — i— <br /> i � <br /> _�_ — __�— <br /> i i <br /> �— — — <br /> i � <br /> � <br /> �- -_ T <br /> 1 � <br /> SUB TOTAL $ ; SUB TOTAL b{f ' <br /> PERMIT $ —'— pERMIT S " �— <br /> � ' <br /> TOTAL FEE $ ' TOTAL FEE E ' <br /> FRONTSE7B�CN REARSETBACN SI�ESElORCB P�)NGIIE {NUMOER FEE�� .i • 'l�j RECEIPTNO. <br /> (1�� '1� �)� �.�i��L.. '"�. `�l . <br /> / <br /> usezoNE ioren[U VACANTSIIF FEES VALUATION rEE <br /> CI YFS �DQNO �UILDING � �•, �)� •�r �J—� ����� <br /> fYFEOFLONSI�ILOWABIF TYPfOiCOH5fAL111AL �Car�ucr uooim�vuNGuuns `_� �« <br /> �� �— <br /> � ^�j �Aam �� pl UMHING � <br /> i <br /> SREOFiYl�f �F��C,e� NOOFSiORIES OASEMENt —i—� <br /> MECI IANICAL i <br /> . Q � I 1 YES �NO �— --- <br /> � <br /> OGC ANCYLO�� FIOESPIINNLEIiSRE00 IIEIGIITI.R.IIiAiIOq OIIIER � <br /> Z� t�(ves l � No • "' srnir:uuu.uiNc suncnnnce _ J_ ��� 1 <br /> nensor+ronsrnivKi.ens -- — — " i <br /> SINE GNERGY Sl1RC11ARGE � <br /> i <br /> MPI.IG.ITIONACQOY PUNSMPiIOVEDOV � I <br /> � CITY OF EVERETT PUI3IIC WORKS � <br /> �� .� I.00AL SALES ' <br /> �'-l;'' ��i" TAX COOE IS 3105 1otA� '}C.Li' .' � <br />