Laserfiche WebLink
bi�PL.1�A'TICi�I FOF� �O�IS`TFiI��� .JNI �E��N�ST <'��""�" <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> everett --- —, <br /> �HEATING SYSTEM: �,J GAS �ELGCTRIC __J_ __. ___� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL _ PLUMBING SIGN <br /> MAIL4DDRE55 CiiV l ]iP t��,�f <br /> OWNER J � � <br /> r+ ` � 1 � <br /> � � � ��r,su,.i � /'r;so�,c,��5 /.,. � i j> � ._ ; ;n P�oNF -- _ <br /> CE i[NANT /bIAILAyD'p-RE55 ,�/� CITY / ZIP <br /> io�� c� C%L/ � /�—Lc�l;'�2� - . //�Y� ! �7 ,. . �i ' <br /> 7 N f11 AnCNITECTOR0E5�1GN/ER� ILFDDRE55 GRY ZIP PlIONE ! ZP. '-6� U . �'C• <br /> H r� 3 �O ✓'/✓_LF_� c-Si-C�-�.v �Y,.1.Co� �r�;�C� ?7G.,;i'%;�� �C-:.� � u''/'ilc�._t, <br /> H :L H — � CITY ZIP �'H .'- LICEl:SE M <br /> K f) GENER�LCONTRAGTOR MPiIAJtlRE55 � <br /> H 71 <br /> O M O -- "_"_— _ <br /> V ro �� ZiA F�.•,.VE LIGENSEc <br /> N M('� MEC NICALC NTRAGTOR AILA SS y� <br /> y $ i���iL'S/"� � � /��' /7G• '� l 3/'.tl�F i� l/_�A t u'��.i r�. ;Sj?�iG� • — �,�'r. <br /> LTJ O LL QiY ZIV 'PNONE L CENSE N <br /> H r PIUMBiNGGONTRAGtOR AfAILA00NE5S <br /> Q H <br /> � n CJ <br /> H �+J O <br /> P1 • R CLASSOFWORK � � <br /> yy � NEW � ADDITION AC"ERATION � � REPAIR � DEMOLITION � WOODSTOVE/FRPL INSERT , BUILDING RELQJATION <br /> � ,t CONTACTPERSONANDPHONENO <br /> r � <br /> � '> � ,1 /,v'c �, ,...�':. �,'.�� �i'c=,-7 <br /> p y N CONTflACT PPICE OF WORK � �I C�2/ ' f� / <br /> n O N UESCRiBEWORNFND�o UA9��1p TAGEiNVOLVgU� �!�p.�;y(��y �'i/S -q <br /> � ro t., c�',.fu-.�.*,�C' a'.'2Y'%ic�f 7s ncc�o:�,� e,r�c �-'tKJ <br /> ta -��.✓.,.,�i <br /> � H m ano�•oseouseoceu DP�G I HEREBY CERTIFY THAi I HAVE READ AND ExAMINED TNIS <br /> "3 � y APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECL ALL <br /> «� PROVISIONS OF LAWS AND ORDINANCES GOVERNIN6 THIS TVPE OF <br /> IEGt�I�ESGRIPTIONOFPROPERttISNOWNBELOWORRTTAGHFOUFCOFIES) yyORK WILL BE COMPLETEG WITH WHETHER SPECIFIED HEPEW OR <br /> �cr o�ocK aF NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PFiOVI510NS OF ANY <br /> OTNER STATE OR LOCAL LAV!REGULAl7NG CONSTqUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOR2ED BY TFiE <br /> OWNER OF THIS PPOPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS tdADE AND I COMPLY WITH. THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAG. <br /> SiGNATUREOFLONTRAGTORORAVTHORRED.GENT �nlE <br /> / <br /> / <br /> X �/� ,� � <br /> � �:rr:,<.�o ��i�-. , _ - 'i% <br /> n�o�ec.aooaess <br /> � /� APPLICANTSCITYOUSiNE55UCEN5EH0.ANt p5�NE55NAME <br /> j '. � :) ��fj ��C . �G/i7 �Y� �i 2 _ : <br /> I � ���� PLU�dBING ' MECHANICAL --> <br /> �� NO. TYPE OF FIXTURE ON ITEM FEE � -N0- ���-- TYPE OF EOUIPMENT FEE <br /> WATEFl CLOSET(TOILET) AIC-NHNDLG UNI15-H.P. <br /> i BATHTUB ' FORGED AIP.SYSiEMS-B.T.U. M E.A. , <br /> 'r� LAVATOFY(WASH BASIN) UNI7 HEA7ERS-B.T.U. M <br /> �I CLOTHES D?.YERS <br /> SHGWER - <br /> � KITCHEN SINK 8 DISP VENTILATWN FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATERHEATER <br /> � �v CLOTHESWASHER WOGDSTOVE <br /> URINAL METAL FIREFLACE 8 CHIMNEY _ <br /> DRINKING FOUNTAIN FIREPLACE WSERT <br /> FLOOR DRAIN HEAT PUMP <br /> �' BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS--RAINLEA�ERS EXHAUST FAN <br /> � SINK(SERVICE-BAR,ETC.) <br /> �� . — — <br /> �- <br /> � SUB TOTAL 'S ���U ' <br /> SUB TOTAL S - <br /> � PERMIT S PERMIT $ /��_ <br /> � TOTAL FEE S TOTAL FEE S �� , ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSLTBALK PEARSEi�ACK SiDE5E1BACN �LANCHECKNUMOER FEE <br /> RECEiP;NO. <br /> usezor+E �ornaen VACANTSITE FEES VALUATION FEE <br /> BUILD�NG <br /> tYPE0iC0111S.All�WA9l[ lYPEOPCONSt.ACipRI atGqGupcv xoarUwfluxLuvns — <br /> PLUMBING <br /> i, <br /> SIZE OF BLDG. NO OF STORIES 6ASEMENT MECHANICAL �r_ � <br /> GCCUPPNGYLOAp �IPESPRNNLERSPEO'� HEIGHTLIMIiATION ADDITIONALPLANCHECK <br /> OTNER <br /> t�t n50R POi15PRINNLEFS <br /> STATE BUIL�ING SUFCHARGE <br /> iutnKEBv P�nNSnPPROVE�BY CITYOFEVERE7T PUBLICWORKS <br /> LOCALSALES <br /> TAX CODEIS 3105 Tora� <br />