Laserfiche WebLink
APPLICATIC ��1 FOR CONSTRUCT�N PERMIT ��� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />� 1EATING SYSTEM: GAS J ELECTRIC _J —I <br />BUILDINr, DEPARTME.dT <br />259-8810 <br />L i DEMOLITION I_ 1 COMBINATION � BUILDING !! MECHANICAL i=1 PLUMBING I 1 SIGN <br />OWNER h1AILAUDRESS GTY ZIP P110Nf <br />�,�. t 5 ow,�d F2 L',1 i-i-�-�-4� z 90� l��w'�fi EtJEv-�1-f-°F� vr <br />T`NANT IdNLADORE55 CiTV �IP PHONL <br />�RCMITEG7ORDESIGNER ldAILFO�RE55 CITV ZIP PHONE <br />�u.-tf�,--�'r•,E!d���,�,a,�� y�vp�y-�or�� i dN�wlds �j �6�0 ?�s-oSG y <br />GENER�ICONTRACTOR MAILABOS1ti55 GTY IIP PHONC SiATFLICENS@• <br />Ao.��us..-N(�,�si�.�o. T�ox�oy MIAk�, ��Eo �} �{�7s 35`S�i�z 6Mar e o7 nq9 <br />MECMANIC L WN RACI q MAIL <br />Pt,�qE Fa 'irla <br />CONTfi4C7 PRICE OF WORN <br />DESCRIOE WORK AND SOUAI <br />NNL�DDRESS <br />� <br />// y O <br />PROPOSEDUSE Gi BUI <br />a�'�eF <br />LEGAL OESCPIPTION OF PROPEFiT�Vj IS�,H2O�W�N BELOW OR 4TTACH T\YO GOPIE <br />LOT � O BLOCK � OF ���� O <br />/i- • �7l [�� <br />PARLELrA%ID.NUMBER _��/� <br />N ' <br />COYSTRUGT101lLCANLEIIDEN.FD�RESS.iELEPMC <br />PROJECT ADDRGSS� � �� S <br />k <br />PLUM8ING <br />NO. TYPE OF FIXTURE OR 1 <br />WATER CLOSET ( �OILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTflAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLON/PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />_L SINK (SERVICE AR, -TC.) <br />CIiV <br />0 <br />0 <br />i <br />—� <br />SUB TOTAL 5 <br />PERMIT S —� <br />TOTALFEE S , <br />FOR OFFICE USE ONLY: <br />iRONTSLTBnGK REARSET(3ACH <br />/ <br />USE ZONE y�� /� LOT �R A <br />� O l� <br />TYPE Of �C�7N75�1� NOAF STOFIES <br />_.41v I <br />SREOFBLDG. FlRESPRMNLEn5PE0'D <br />( � % �;iF /�U <br />OCCUPANCYlOAO FIREALARIdRWL <br />1 D /UD <br />flEA50N <br />INIAHEBY PLANS�PPROVEOIiV <br />onrr ����'il`�5 <br />SiD[ <br />ziF� rnaNe srni�ucENSEr <br />�3y.�//1 <br />ZIP PHONE STATELICENSEn <br />35s-'�7Sy <br />CONTACT PERSON �ND PNONE NO. <br />i HEREBY CERTIFV THAT I HAVE HEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TR�c AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHGR STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZ�-D BY THE <br />OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOAS LAW 18.27 RCW AND 296.200 W4C. <br />X cJ ���.��. z A-�o9 � <br />S�GNFIURC � DU[ <br />L�iv OUS'rv155 Li:1.N5E f+0 <br />MECHANICAL <br />J0. TYPE OF EQUIPMENT FEE <br />A'C—��HNDLG UNITS—H.P. � <br />FORGED AIR SVSTEMS—B.T.U. M E.A. � <br />i_ <br />UNIT HEATLRS—B.T.U. M i <br />CLOTHESDRYERS � <br />VENTILATION FAN ' <br />RANGEHOOD � <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE IINOOD BURNING� � <br />FIREPLACE INSERT i <br />HFAT PUMP <br />GAS PIPING ' <br />EXHAUST FAN � <br />SUB TOTAL 5 <br />PERMIT 5 <br />fi I FE[ , O I �ECBPi <br />� � �� <br />vncnrut siie FEES <br />�. �. YES NO BUILDING <br />osm_.�� aa�o:nc.�ian6 — <br />�Au"" � PLUMBING <br />� <br />onSE�.�EnT MECHANICAL <br />�-'. YES !� NO <br />HEIGMTLIMITATON AODITIONALPI.ANCHECK <br />OTHER <br />STATE BUILDING SURCHAFGE <br />CITY OF EVERETT pUBLIC WORhS <br />LOCAL SALES <br />TAX CODE IS 3105 Torni <br />;Jd <br />L <br />