Laserfiche WebLink
APPLICATIG_J FOR COI�STRUCT_ �N PERMIT ''`'"`'" <br /> ,,,,,, ,,,,,,;,,,,; TO BE COMPLETED IN INK—PLEASE PRINT � <br /> GIIY O� <br /> everett HEATING SYSTEM ❑GAS J ELECTRIC J _ -_� <br /> BUILDING DEPARTMENT — — <br /> 259-8810 <br /> DEMOLITION COMBINATION BIIILDING MECHANICAL LUMBING SIGN <br /> n����pq �! IARIIADUPESI$ /� CIiY ZIP PHO��E <br /> ���.. /.' CqtiCi('v'.l-X7,( '�'� /C�� /(G<Llt{� �i'�ll.C� �`Jl �SY' Y37(.7 <br /> ���Ip,�4~'=V MAILAppRE S CItY ZIP GNONE <br /> „il�at[Ci0RDE51GNER MAIIPpDPE55 GITV ZiP PNONE <br /> Gf'dRALGONTPAGiOR �A�LA�ORE55 CRV 21P PMONC LICENSE� <br /> !��.(.�InNiCAIGONIRAGiOP MAILADORE55 pTv ZiF rtlONE UGENSE• <br /> y �� i`lU!'OirvGCUNiRAC10R M�ILRODRE55 C11V 21P PNONE LICENSE• <br /> � � y � , /'�/,� ��� �� �oz., �y„��w�,Q �s� Yti -�53�4y���4NrPliZtcZ. <br /> o �x «Ass ��v NK "'7J � � <br /> y y y NEW AODITION ALTEfiATION ✓REPAIR DEh10LITION WOODSTOVE/FRPL INSERT BUILDMG RELOCATION <br /> � <br /> � CONiAGT P[RSON AND PPON[NO <br /> COViHALi PRICEOF WORK <br /> �H]� CL SG�UpL WORK AND SOUARE FOOiA3E INVGLVEO <br /> '�H 'il — <br /> U1N r�n;;voseous�oaouaortm I HEREBV CERTIFY THAT I HAVE READ ANO EXAMINED THIS <br /> �,�,� - S/� .,Z. �S�� G /�Iy _ APPLICATION AN�KNOW THE SAME TO�E TRUE AND COF7RECT ALL <br /> � b ucni oe NIPLIONOF�POPERLV iS 10Y1N BEIOWORRTTACHFWRCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COAIPLETED WI1H WHE7HER SPECIFIED HEREIN OR <br /> M <br /> iui e�oc� oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GN[ <br /> M [�iJ g AUTHORI7Y TO VIpLATE OR CANCEL THE PROVISIONS OF ANV <br /> 6�• O OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR 7HE <br /> �y� PERFORIdANCE CF CONSTRUCTION.THAT I AM AUTHORIZED DY THE <br /> OWNER OF THIS 'FOPER7V TO PERFORM THE WORh FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> y y CONTRACTORSLAW1B27RCW AND296200WAC. <br /> g �„� ;IGNniUA[O�WNTRACi0ROf1AUT110RIZLDAGENi �AiL <br /> �]b� - <br /> �� � PR:LCCI A[�DIlE55 � ��- S ���1 /�1��%� <br /> yp(p � /L � � • ��C! APPLICANIS �USVIESSIiCENSENOD1�0U5ME55NAM[ <br /> G LlC � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ' �� � � WATER CLOSET ITOIIET� /U � ArC—NHNDI G UNITS—H P. _ <br /> � BATH7UB /O ; FORCED AIR SYSiEMS—B.T.U. M E.A. <br /> � � — '7, LAVA70RV IWASH BASIN� i0 i UNIT HEATERS—B.T.U. M <br /> � SHOWER CLOTNES DRVERS <br /> . KITCHEN SINK 8 DISP r � VENTILATION FAN <br /> � DISNWASHER RANGE HOOD <br /> � LAUNDHV TRAY WATER HEATEF 6 ' fa <br /> � I^� CLOTHES WASHER $ � WOOD STOVE <br /> ��� / URINAL METAL FIqEPLACE 8 CHIMNEV <br /> '� DRINKINGFOUNTAVJ fIREPLACEINSERT � <br /> �T <br /> ' FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> 'i �'�1 ROOFDRAINS—RAWLEADERS E%HAUSTPAN _ <br /> SINKISERVICE—BAR.ETC.) <br /> �� T6 <br /> � _ � — <br /> ��1 _�_ <br /> � <br /> SUB TOTAL S y.` ' SUB TOTAL 5 /u ; S� <br /> ��� _ PERMIT 5 PERMIT S /f� I - <br /> ��', TOTAL FEE $ �/J ' TOTAL FEE S i ' > C <br /> FOR OFFICE USE ONLY: <br /> uiOMS[LAACR REARS[TBACK SIDESEIBACN PLANCIIECNtNME3[1i FE[ RECFiPiNO <br /> usr zorre LOL RRU v�cnHT srtc FEES VALUATION FEE <br /> BUILOMG <br /> r,r[CtCONiSAIlOWA6lE lYPEOiGON51,1CiJ.1l occvv�xcr xoruowt�us'�.�u ---- <br /> aeouo PLUM�ING �%U <br /> .,i,:OF OIOG NO OF StORiEs BASEMENi MCCMANICAL ,�/ '� <br /> t,::wPANGVIOAD FiRESPPNNLEFSREOD MEIGNTtIMItPTiON ADDITIONALPLANCHECK <br /> OTHEfl <br /> in nsON PoR SPqiNKtERS �� <br /> STATE OUIIDING SURCMARGE <br /> r.�nx�nr vini+snr-rnovcour CITYOFEVERETT PU�uGWOPKS <br /> LOCALSALFS <br /> TAX COOE IS:�105 T�TA� � � ; 5 a <br />