Laserfiche WebLink
,.�. �-��'' � � -1 <br /> �p�L.�GA'A'1�'DF. FOR CONSTRFIGT1�,t�; P�RIWIT: ; .e�e«" <br /> „ moeve�green � TO BE COMPLETED IN INK—PLEASE PRiNT � L. I'��U.� ," ;:' i�`_II .�' '� I <br /> CITY OF • � � <br /> everett - _ ...... <br /> � HEATING SYSTEId: ❑GAS ❑ELECTFIC ❑ UF��V RFTr <br /> BUILDING DEPARTMGNT � nrl;s p����. <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING 'MECHANICAL ; PLUMBING �IGN <br /> � '+ OWNEF MAILAO�RC55 CrtV ZiP PHONE � <br /> ��e2�c�s�oc�'� �� �� <3o�f cy,�„�ur� � �z.i� /`Sd3G '7 ��/- oSSZ <br /> TENFNi MARADORE55 CTY ZIP PHONE <br /> �r� ..� zo � s� 17��' � ��fi /� c� `aCE�' I <br /> AqCHITECTOfl�EStGNER M41LAU�PE35 CITY ZP PMONE <br /> GENEPRLCONTRACTO S ` dA�lM100RE55 CITY ZiP PHONE LICENSE+ <br /> HOH `�iA.�se� � Y'E'f0/ G�Z�]-`�Y%C A/IezlN �- /v/•,� <br /> ��r� /��tc " '��}nl AIPc`.J--�/aJ ✓SUX—1?l Yyrr �1� /-� +� . <br /> IAELHRNICALCONTRACTOR AAILAD� �NE55 QTV ZIP P40NE LICENSE� <br /> m�r'L' — <br /> Cr �"� PLUMBINGGONTBACTOR IANL�DOFE55 CITY ZIP :H01lE LICENSEI <br /> a�lcn <br /> y .��r H C1A550F WORH <br /> �s', y� NEW '�.--� ADD�TION ..' ALTERATION .. . REPAIF . �: DEMOLITION �. ���. WOODSTOVFIFRPL INSERT �� �. BUIIDING fiELOCATION <br /> � W[NiAnCT FEFSON ANp PHON/E�NO. <br /> � �H CONTIlACTPRICEOFWORK V � C' (� e //' / L ` <br /> H L'� �ESCRIOE 1VOPH AND SOUABE FOOTAG'c INVOLVED FI� .rl <br /> T� <br /> E� o C� Tastn// ��Ne 3o�c s 3.J Z•5 /O �s w -:r / <br /> yd PqOPO5EDU5EOF0UIL01NG I HEREBY CER7IFY THAT I HAVE FEAD AND EXAMINED THIS <br /> .��q n��l7JJ ��4� �J�� . �p?y� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> ��� iecaioe a� TIONJFPdOPERttISHOWNBELOWORATIDCNFUURCOFIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> H q WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> y� y 3 �or OLOCH OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> 9 LTJ AUTHORITY TO VIOLATE OR CANCEL THE PROVISICNS OF AN1' <br /> � /' <br /> t� H y f�i �,.yy�'. G, OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> Fy y l�7=- PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZE�BY THE <br /> r H OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> �C by APPL�CATION IS MADE hN� I COMP�Y WITH THE STATE <br /> g �t+ CONTRACTORS LA 827 RCW AND 296200 WAC. <br /> fjj [s] SIGNATUR[OFC01 CTOR AAUTHORREDAGENT DATE <br /> y �[�i� ,, �,7 .S, <br /> � aaaecraooaess A.c.� No J��S f/- DJ/'S� . <br /> � � 2 P AVVLIGANTSCiTV0U51NE55LICEN5EN0./�%DOUSMESSNNAE <br /> � � <br /> PLUMBIIJG MECHANICAL <br /> j NO. TYPE OF FI%TURE OP.ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) AI�NHNDLG UNITS—H.P. <br /> I� � BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> �� LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> I CLOTHES DRYERS � <br /> SHOWER <br /> II ;a. � KITCHEN SINK 8 DISP VENTILATION FAN �� <br /> � DISHWASHER RANGE h100D <br /> I � LAUNDRY TRAY WATER HEATER , <br /> '� .. CLOTHES WASHER WOOD STOVE ___ ���, <br /> 'd"� � METAL FIREPLACE 8 CHIMNEY <br /> URINAL <br /> I ��! DRINKINGFOUNTAIN i FIREPUICEINSERT i ___ <br /> I <br /> FLOOR DRAIN HEAT FUMP _ <br /> �.� � BACKfLOW PREVENTERS GAS PIPIN6 <br /> !I � ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> � SINK�SERVICE—BAF.ET0.) <br /> i <br /> ` 1�' � <br /> ... � <br /> � <br /> ' � SUB l'OTAL S i Sl1B TOTAL S i <br /> � I I PERMIT 5 _ PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 <br /> , FOR OFFICE USE ONLY: <br /> � FPONTSET9ACN RE�RSFTOAIX SIpE5ET8ACK PIANCNECMNUMBER PEE FECEIPTNO. <br /> usezor+e yc,rneea vncaNTsite FEES VALUATION FEE i <br /> �'�' ZS � BUILDING <br /> lYPEOFCOIRSALLOWhBIE iYPEQ�CONSi.RCi�AI O:iwxsCr xodvn¢uecu•.ns <br /> �anw � PLUTA�ING ' <br /> SIZEOiBL�G. ND.oFSTOf11E5 BASEAIENi MECHANICAI '� <br /> oCCUPANCv�onu FlRESPfiN8LER5tiEb0 i�[tGHiurartAiio�� A�DITIONALPLANCHECK <br /> P na .�� ' <br /> � � �� OTNEfl .�� � //�Q � � <br /> REPSONi005PPWNL[RS � i� <br /> STATE BUILDING SURCHFRGE <br /> INiAR[OY �l� SAPPPOY[OOY CITYOFEVERETT PUBLICWORK$ I <br /> LOCALSALES � <br /> �l� TAX CO�E IS 3105 T�TpL �3 j S� ! <br />