Laserfiche WebLink
� � APPLICATIa.J FOR CONSTRUCT.JN PERMIT <br /> TO BE COMPLETED IN BLACK 1�7K—PLEASE PRINT �,����� <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS ❑ELECTRIC I,� <br /> 259-8810 <br /> DEMOLITION jC COMBINATION X BUILDING a MECHANICAL �lPLUMBING SIGN <br /> OWNER MqILApORESS CITY ZIP PMONE <br /> �v���„�o�k �, ��N isfi n� 5�= r- r 7r �b-�« z --� ��� � <br /> TENFNT MAIL qDORESS GITY 21P PMONE <br /> ARCNITECTORDESIGNER MAILqpORESS CITY 21P PNONE <br /> C�>/�) IVI I � 1 33y - �S� <br /> GENERALCONTPACTOR MAILqDORE55 CITV 21P PHGNE STATE�ICENSE♦ <br /> _ U c.:.,.�r /^ !f �y2 +� j �1-'4�7 ---� <br /> MECHqNICALCONTFRCTOR MAILADDRE55 CITV ..1 2iP PHONE STATELICENSEI <br /> �� � L �� , f - 3�1C� ! i �c� t� ve �— �e'i•Il `�YZ 3 �� G14� <br /> PIOM�INGCONTR�CTOR ) MAILq00RE55 CIIYTh 21P PNONE STATEIICENS[e <br /> J'Ullc� Sc��Np �7(nl� �C7�1 .iC�r,��.... 1.CIL Cft'I / ��'�:Y 3V7 �/Z�(1 <br /> LLA55 f WORK <br /> `x NEW ADDITION ltLTERATION REPAIR DEMOLITION WOODSTOVE�FRPL INSERT BUILDING RELOCATION <br /> / LONTACTI PERSON AIND PHONE NO <br /> CONiRPCTPRICEOFWJRN _�(�O(jf Qlt_ L/J �C{� J���f�c -J yfdC - y'��1� <br /> DESCPIBE WORK ANO SOUAPE FOOTAGE INVOLVED � - <br /> i .,, Id , � i cv °�la„ ��s�c r <br /> PROPOSED 115E OF BUIL�ING <br /> � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> S �..�I Y H,,. I .. APPLICATION AND KNOW THE SAM[TO 8E TRUE AND CORRECL ALL <br /> �ecn�oesc TION OF PNOPERT �SHOWNBELOW OR�TIACNFOUH GOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> r�"� I 1 �� WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior 8C o�oce c..�— oF /iJ'TT.Lz[ � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> T — <br /> �S AUTHORITY TO VIOLATE Cq CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUI:TION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PAOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> — X��,�1� 4 7� ..,✓ �-�� -9�� <br /> PROJECT ADDRESS „�crv��ur . DerE <br /> �/O �� �� � Ci1Vp115iN[SS�lLlNS[NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OP FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) �� — A�C—A/HNDLG UNITS—H.P. <br /> � BATHTUB 5; — I FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN� UNIT HEATERS—B.T.U. M <br /> / SHOWER CLOTHESDAYERS —�— <br /> � KITGHEN SINK 8 DISP —i— VENTILATION FAN <br /> DISHWASHER — / RANGE HOOD —r— <br /> LAUhDRY TRAY ' WATER HEATER <br /> J CLOTHES WASHER — WOODSTOVE � <br /> URINAL METAL fIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS / GAS PIPING <br /> ROOF DRAINS—RAINLEADERS 3 EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � <br /> ' C <br /> i <br /> � <br /> SUB TOTAL $ SUB TOTAL $ <br /> PERMIT S PERMIT $ <br /> TOTALFEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> fFONTSEiBACK REARSETBFCN SIDESEiBACK PIANCHECKNUM1IBER P[E RECEIPTNO <br /> �� S' 375'�/ 3a7• "3 �7iD75— <br /> I USEZON[ LOTANE4 VAClN141iE <br /> i FEES VALUATION FEE <br /> Z—� 9 Y�S BUIl01NG 71, 907 . /3� <br /> rvveo�coxis.auowne�e trr[ vcor�sr.ncmnt occu�.rcr r.�oro�t�n��•;a�•,,s <br /> � P,3 + _ <br /> � � PLUMBING J J <br /> SIZ�QF�BLpG NOqFSiORIES DASEMENT ��-- <br /> I3SF1 SF t MECHANICAL /�,�J� � <br /> ' 67 s G.o2 I No <br /> oGCU`P,�.N�CY"LOnU FIRESPRNKLERSREO'D NEIGNiuhutanON ADDITIONALPLANCHECK � -� <br /> �v � �� �' SPqINKLER <br /> aEnsOnFo� asrawHiens <br /> STATE OUILDING SURCHARGE i�; i;/) <br /> � <br /> INTANE BY PLANSAPPPOVED OV CITY OF EVERETT PU9LIC WORKS �/�i — <br /> � LOCAL SALES �_ <br /> JI� '�3i )L TAR CODE IS 3105 TOTAL � o� p� <br /> 1�J0 � 0 <br /> . �_ es'i S 89 <br />