Laserfiche WebLink
APPLICATiI�I FOR CONSTRUC�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: �J GAS LJ ELECTRIC J <br /> BUILDIhG DEPARTMENT <br /> 259-6810 <br /> DEMOLITION COMBINATION BUILDING �C MECHANICAL PLUMBING SIGN <br /> OWNER MAIL ADDRE55 CITY ZiP PNONE <br /> /�icL �� �� J�.. n �/ y' - ' ral/1,� 5� ��v`! 1 y .21c3' <br /> ; r3-��zz <br /> TENANT MRIL��ORE55 CItV ZIP PHONE <br /> ARCNITECT OF DESIGNER MAIt FDDPESS CIiY ZiP PMONE <br /> GEN[RAL CONTPACTOR MRiL ADDR[SS GITV 21P PHONE STATE IiGENSE/ <br /> MECHANIGAL CONiRRCTOA MRII ApDRe55 CITV 21P PHON[ STATE IILENSE� <br /> GLUMBING CONTflFCTOR MAIL ADORESS CRV ZIP PNONE S1ATE UCENSE� <br /> :USS OF WORK <br /> NEW �� �. ADDIiION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING R[LOCATION <br /> CONTACT PEFSGN FNp PNpNE NO <br /> ^-C �/ '� �J <br /> GONTRACT PRICE OF WOPK �l � U ��, ;� G � /J O l) /' I nT4 i� —� � _� Q � l '�` <br /> O[SCRIBE WORNANOSOUARE FOOTAGE INVOLVED <br /> PPOPOSEOUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAMC TO BE TRUE AND CORRECT.ALL <br /> LEGR��ESCRIPtIOhOFPROPtRTVISNOVMBELOWORPTTAGMFOUFLOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISNPEOF <br /> WORK WILL DE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT oiocn oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUC110N OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEfiFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> ���a _ 3 ,��5� x r�z��, �.�:.__�.._.� ,,-���-�:,� <br /> � FR0.IEGTADORE55 siarvntunE Oe*[ <br /> GItY BUSINESS I IC�NG(N(1 <br /> ' PLUMBING MECHANICAL � <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �� WATER CLOSET(TOILET) AiC—AMNDLG UNITS—H.P. <br /> BATHTU6 FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> T <br /> SHOWER CLOTHES DRYERS _ <br /> KITCHEN SINK 8 DISP VENTILATION FAN ' <br /> T <br /> DISHIYASHER RANGE HOOD _ <br /> LAUNDFiY TRAY '.YAiER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSEflT � <br /> r— <br /> FLOOR DRAIN HEAT PUMP _ � <br /> BACKFLOW PREVENTERS GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS (�� EXHAUST FAN p� c'I� T— <br /> SINK(SERVICE—BAR,ETC.) � <br /> i <br /> � <br /> SUBTOTAI $ SUBTOTAL S <br /> PERMIT 5 PE(iMIT S <br /> TOTALFEE S � TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> PRONTSE7BACK REAFSETBPCN SIDESETBRCK PIANLNECKNt1M0EF FEE �CGE�PLNO <br /> 3SS;7 <br /> usezone iornAEn vacnursiTe FEES VALUATION FEE <br /> BUILDWG <br /> tYPEOfC'Y15ALLaWFBIE tVPEOFCONSi.ACtURL acw�nw x00rpH���iixcur'S <br /> ceou� p�UMBING <br /> SREOFBLD6. NOAFSTORIES BASEMENT MECHANICAL � <br /> OCLUPANCY LOPD FIRE SPRNKLEPS REOD NEIGNT IIMiTATiON ADDITiONAL PLAN CHECK <br /> i <br /> SPRINKLER <br /> REl.SON FUR SPPINKLERS <br /> STATE BUILDING SURCHARGE i <br /> i <br /> iNTFK[OY PLANS APPROVE09Y CITY OF EVERE7T PUBLIC WORK$ <br /> LOCAL SALES <br /> TAX CODEIS 3105 TOTAL <br />