Laserfiche WebLink
en���� <br />CITV OF <br />everett <br />259-8745 <br />"�' C'�`)NSTRUCTION <br />PERNiIT <br />PERMITNO. � 9522 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING [a MECHANICAL ❑ PLUMBING ❑ SIG�' <br />OWNEF MnILR00RE55 CITY 21P PNONE <br />Dean Moulton 3722 Rockefeller Everett, WA 98201 252-0972 <br />/.NCMttECTOfi0E51GNER MAILADDRE55 CITY Z�P PMCNE <br />GENENALCONTRACTOR MqLLp�fdESS CITV ZIP PHONE LICENSE� <br />MECNRNICRLCONTRAGTOR MRIL4DORE55 CITY 21P PiANE UCENSE� <br />Owner <br />VLIIMOINGCONTRRCTOP. MAILADDRESS CITY 21P PMONE LICENSE� <br />L�A55 OF WORK <br />❑ NEW � ADDITION <br />VRIU�TION OF WORK <br />t <br />Install Woodstove <br />�ERT SOIIRCE <br />❑ ELECTRICITY ❑ GAS <br />me <br />LOT _ 6lOCN _ <br />3722 Rockefeller <br />PLUM8ING <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVATORY�WPSH BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRiNHING FOUNTAIN <br />FLOOR ORAIN <br />6ACKFLOW PREVENTERS <br />ROOF DRAINS -- RAINLEADERS <br />SINK �SERVICE — BAR, EiC.) <br />SUBTOTAL <br />PEPMIT <br />TOTALFEE <br />USE20NE <br />Oi OLDG � NO OF STORIES <br />Af�PUCATiONACC �V <br />S.H. <br />❑ ALTEHAiION ❑ REPAIR <br />❑ WOODSTOVE <br />❑ DEMOLITION <br />❑ OTHEH <br />❑ BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />l'IOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />S��ATE OR IOCAL LAW FEGULATING CONSTRUCTION OR <br />THE PEHFOFMANCE Of CONSTRUCTION. <br />514NAiUR[ OF CDNTfiACTOfI. /.UTHORIZ[D FGENT.OR OWNER OATE <br />X <br />MECHANICAL <br />FEE NO. TYPE OF EQUIPMENT <br />A/C — A/MNDLG UNITS — HP. <br />REFRIGERATION UNITS H P. EA. <br />DOILERS — B.T.0 /H P. <br />GAS FIRED A C. UNIiS — B.T.0 <br />POFCED AIR SYSTEMS — B T.U. M EA. <br />WALLHEATERS—�SU. M <br />UNIT NEATEflS — OS.U. M <br />EVAPORATIVF COOLERS <br />CLOTHESORVCRS <br />VENTILATIO� fAN <br />FANGEHOOD <br />WATERHEATER <br />1 WOODSTOVE <br />METAI FIREPLACE 8 CHIMNEV <br />FIREPLACEINSER7 <br />HEAT FUh1P <br />G�5 PIPIN 3 <br />EXHAUSiFAN <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />PLANCHECNNUMBER FEE <br />o:E�'oNo I FEES <br />NO OF OWELIING UNITS <br />APP/V fOR ISSUANCE UY <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />VALUATION FEE <br />5 <br />Sec.30ale) <br />STATE BUILDING SURCHARGE <br />STFTEENERGYSURCHARGE <br />DRIVEWAV PERMIT <br />TOTAL <br />PEflMIT YALIDATION <br />WHEN PROPERLV VALIDATED pN THIS SPACE) THIS IS YOUR PERM17 <br />Ai':�:�,lL�:; I ;::_ <br />30 <br />N <br />N <br />L.C� <br />O7 <br />� <br />