Laserfiche WebLink
QPPLICATIC�+1 FCR COIVSTRUC'�-�N PERMIT e�e�ett ,I <br /> Ne Everg�oon TO BE COMPLETED IN INK—PLEASE PRINT � I <br /> CIN OF I <br /> ev�e rett HEATING SYSTEM: 17 GAS �1 ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> Ni pEMOLITION I I COMBI��ATIGN I I �UILDING I J MECHANICAL I J PLUMBING f:l SIGN <br /> OKNEfl MAILA�pRE55 CITY ZIP PNONE �f+'�/��Q� <br /> ����Uec;e2, i�HRTNe�2a `/� T�euNBw�a�, l000 SE EUeReTr lnraupy.E wAy,Su�r��ar, <br /> T��Jr1NT MAILADORESS CITY /�G� 7�Ps �QRQ{�PMr �1QLL wqy • inr R1�aR <br /> i3oE�nra Comm¢rtcia� IalRf�l/iNL �o EveRerr , U.�A <br /> G.6GMITECTOROESIGNER MRILAD�RESS QTY 21P PHONE <br /> (3op„�1y^-,�11jlp22cia� �I2n�k1NE C°o <br /> — , <br /> GENEP4LCONTRRCTOR MAILAD�RESS CITV ZIP PMONE UCENSEII I <br /> rn mr 4e�urc� s • ly9o� NE yo` sr , RzomoNr� , WQ 9$05'� mmz �nr �T j <br /> MECNANILALCONiRACTOR MRILAOORE55 CITY ZIF PHONE LICENSE/ . � <br /> r8�-- s�ay I <br /> PLUMBIk9CONTRACTOR MAILA�ORESS CITV ZIP PHONE UCENSEY I <br /> N IR I <br /> CLASS OF WOflK <br /> I� NEW G ADDITION �O ALTctlATION f-I REPAIR !�Q DEMOLITION I�1 WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br /> � Ov GONTACT PERSON AND PhONE NO. i <br /> CONTRAGT PRICE OP WOPK � '� <br /> DESCflIBE WORN FNO SOUARE F00T4GE INVOLVED I <br /> Sl000 e F� e �Rver �A��-r <br /> PflOPOSEDIISEOFB71L01NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Q ����� APPLICATION AND KNGW TH8 SAME TO BE TRUE AND CORRECT.ALL . <br /> LEGAlDESCRIPTIONOFPqOPEflN�SNGWNBELOWORATfACHF00RCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINuTHISTYPEOF � <br /> WORK WILL pE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br /> �oT eiocK oF NOT. THE GRANTIN;, OF A PERMiT DOES NOT PFiESUME TO GIVE <br /> AUTHORiTY TO VIOLATE OR CANCEL THF PROVISIONS OF ANY <br /> �'Q-�� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> - PERFORMANCE OF CONSTflUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNF.R OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> —� APPLICATION IS MADE AND I COtdPLY WITH THE STATE . <br /> � CONTRACTORS LAW 1B.27 RCW AND 296.200 WAC. 9 � <br /> SIGNFTUNEOFCONTflACTOROFAUTHORIZEDAGENi DATE �P/'jo/ / ' <br /> PF0.IECTAUOPESS /S y� �INYVY�. /�. �CJO/ /•��V� '_ l �. <br /> OO� �� CRQ•IT � �IaIL U' �e(L �'PP���ANTSCRYBUSINESSLILENSENO.AN�BUSINESSNAME , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXT'URE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE � <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.R � ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> T <br /> SHOWER � CLOTHES DRYERS � � <br /> KITCFiEN SINK&DISP � VENTILATION FAN ; • <br /> DISHWASHER � RANGE HOOD � . <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOODSI'OVE � <br /> UHINAL ' METAL FIREPLACE 8 CHIMN —�— <br /> �-- <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> r— <br /> FLOOR DRAIN � NEAT PU�v1P � <br /> BACKFLOW PRE NTERS ; GAS f`IPING ; <br /> ROOF DRAIN fiAiNLEADERS � EXHAUST FAN —�— <br /> _ .,-- <br /> SINK(SE CE—BAR,ETC.) ; <br /> — � <br /> � <br /> --�— <br /> � � <br /> � — � <br /> � <br /> T T <br /> i i <br /> SUB TOTAL $ ; SUB TOTAL $ ' � <br /> PERMIT $ PEAMIT $ � <br /> TOTALFEE $ 1J A ' TOTALFEE $ ti� � <br /> FOR OFFICE USE ONLY: <br /> FRUNTSETBACK PEARSETBACK SIOESETBACN PIANCMECKNUMBER FEE PELEIP7N0. <br /> 115EZONE �OTAflEA VACRNTSITE FEES VALUATION FEE � <br /> BUIL�ING s2 � aU <br /> TYPEOFCONiS.PLLOWABLE iYPEOftONSTRCiURI atimeN[r HoarDwFuixGUNits <br /> �p�P PLUMBING � <br /> T <br /> SIZE Of BLDG. NO.OF STORIES �ASEMENT MECHANICAL � <br /> i <br /> i <br /> OCCUPANCYIOAD FIflESPRNKLER5RE0'� MEIGHTLIMI�ATION A�DITIONALPLANCHECK i <br /> i <br /> OTHER ' <br /> i <br /> PERSONFORSPRINHIERS �-- . <br /> STATE BUILDING SURCHARGE iSl} <br /> INTAKE DY PLANS APPROVED�V i �,' <br /> CITY OF EVERETT PUBLIC WORNS , <br /> LOCAL SALES <br /> ���,� TAK CODE IS 3105 TOTAL � �SO � <br />