Laserfiche WebLink
; APPLICkf10N FOR CONSTR�TION <br />� PERMIT <br />the Everpreen everetl <br />CITY OF � <br />; everett <br />BUILDING DEPARTMENT <br />259•B810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNEP M�ILAD�qE55 CitY ZIP PNONE <br />'�.Sco�/" � �RA/1� .���a� -S�f rt,�� �%��� 339—//,�� <br />TEN�Nf <br />MAllI00RE55 GIiY 21P PNONE <br />.j ARGMIiEGTOR0E5i0NER MPIADORESS Cilv ZiP PnONE <br />`'i OENERALCONTNRCTOR IAnILADDf1E55 CIIY IpIPp PMONE UCENSE• <br />� dGY(/���n �o�� SyY"S� /=vel"�� /J�T�� 33�—���� <br />. MELM�NIC�LGONiR�CiOR MUL�DURE55 GIIY 2P PM IE LIGENSE• <br />' MRIL�UDRE55 GIIY ZIP PIIONE LIGENSE• <br />PUIMBINOCOHIR�GiOR <br />N <br />cuss or v.ur� <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OFMOL�7�ON ❑ WOODSTOVE/FRPI. iNSERT ❑ BUILDIN� RELOCAiION <br />1 ��ier'i �to 1NIl f�Hf1NE NO <br />!' <br />/ <br />�pT eloGn oF <br />I <br />• �, Z�''� -'� S, �17''' <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATERCLOSETITOILEn <br />BATNTUB <br />I.AVATORY IWASN BASIN� <br />SHOWER <br />KITCHEN SINK 8 �ISP. <br />DISHWASHER <br />LAUNDRVTRAY <br />CLO7HE5 WASHER <br />URINAL <br />DRINKING FOUNTAIN _ <br />FLOOR DRAIN <br />aACKFLOW PREVEN7ER5 <br />� USEZONE LOiARG VAVHi51iE <br />❑ YE5 ❑ NO <br />TYPEOFGONST. OGCUPANCVGROUP NOOiDWELLII <br />' ALLOW�BLE/�CTUAL <br />6REOFBLW. HOAFSiORlE9 BSMI. OGClORO <br />Ll Y <br />n r+ <br />� HC1611i LIMIIRI <br />' FIRESPRINKLERSREOUIP[0 ❑ VES ❑ NO <br />RPPLIGAiION�.� PLANSAPPR.BY <br />I HEREDY CERT IPV 1 HAT I HAVE PEAD ANO E%AMINED THIS APPUCATION AN D <br />KNOW THE SAME TO Bfl iRUE AND W(7RECL ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS 1YPE OF WORK WILL BE COMPLETED WI7M <br />WHETHER SPBCIFIED HEREIN OR NOT.THE GRANTINGOFA PERMITDOESNOT <br />PRESUME TO GIVE AUiNORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTH ER fi7ATE OR LOCAL LAW REGUTATING CONSTRUCTION OR TH E PE(b <br />FOFiMANCE OP CONSTHUCTION. THAT I AM AUTHORIZED BYTHE OWNER OF <br />THISPROPERTVTOPERFOfiMTHEN'ORKFORWHICHAPPLICATIONISMADE � <br />AND I COMPLY WI7H THE STATE CONTRACTORS LAW 1827 RCW AND � <br />296.200 WAC. i <br />S�GNAIUREOfCONIlIFC10ROIIAUf110R11[D�GENi DRE , <br />X � f�_1���-.�f� //�5��� �� <br />/,PPUGA��U RESSULENSENOANDBUSMESSNAME <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />NC— A/I�NDLG UNITS— H.P. <br />FORCED AIR SVSTEMS— B.T.U. M EA <br />UNI( HEATERS— B.T.U. M <br />CLOTHES DRYEf75 <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />FIREPLACEINSERT <br />HEAT PUMP _ <br />GAS PIPING <br />E%IIAUST FAN <br />SUB <br />TOTAL <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BU�IDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBUC WORKS <br />T074L <br />S <br />5 <br />$ <br />FEE <br />