Laserfiche WebLink
i <br /> ; APPLICATI�N FOR CONSTRUCTiON PERMIT <br /> everett <br /> fM Every.rnn e <br /> CIl Y OF <br /> ; everett <br /> BUILDING DEPARTMENT ' <br /> 259-88�0 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION I i COMBINATION I ! BUILDING I i MECHANICAL I I PLUMBING i] SIGN <br /> py� � uMl�oDnEss c / Cltv 21r Cr10NE <br /> + �QifhA �O/�l�Oh1 S�.TU^ .XLI�kr1��y �U' Z ,5 S'( ��l f/ — <br /> T�qµT MAIIADOV[55 CIIY IIP PIIq1E <br /> IIRCHITEGT Gi OESIGNER M�R��ORE55 CITV 21P P��E <br /> GENERQCONTR�GTON M�II��DRE55 CITV 21P YNONE IICENSE� <br /> MEGN�NIC�L G iR�.TOq M�IL�DDRESS CI1V ZIP �MONE LIGENSE� <br /> A�_w_ A/o�+� f• 3���-�1-� � Rrt �✓T SPzo�fS-r3l/ /Um�-��� �37/cT <br /> VIUMBMOCONiR�CTOR M�IL�ODN )S CI1Y 2�P PIIONE LICENSE� <br /> ���$$pF WJNN �/� <br /> j ❑ NEW I I ADDITION iFMALTERATION ! � REPAIR I I DEMOLITION I I WOODS(OVE/FRPL INSEFi I I BUILDINO RELOCATION <br /> 1 TEIWIiMPROVEMEN1IX1M1ERqRPEMOD LONIV CONUCiP[RSONANDPHONENO. <br /> CONTR�GT PRICE OF N�Mk: /�1� <br /> � pE$CpllE Wqik A 0 SOU�RE fOO1�GE MVIXVED <br /> i ��srb, � FRN $ A,�I4 <br /> vnproscousepreuao � r I HEREBV CER?IFV THAT I HAVE READ AND EXAMINED THIS <br /> �� APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORHECT.ALL <br /> �pkpE ^7pqpFpqpPERTY� NON?Ib[IOWO��T7�GNFWRCA�lES) PROVISiONSOFLAWSANDORDINANCESGOVERNINQTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> �or eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO OIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> I OTHEF STATE OR LOCAL UW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTMORIZEO BV TME <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOfl WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 flCW AND 296200 WAC. <br /> SIGN�TUREOFCONTP�CTOAOR�UTVqRRE��OENT DATE <br /> i y /`� <br /> r /� <br /> ���'L1,� <br /> � PNO.IEGT�DORESS �. L <br /> ' -JI/O - JT � 1 ��PLIC�NTSCItYBU5ME55LIC SENO �NDBUSIHESSNMIE <br /> 4 4/j <br /> .��� MECHANICl11 � � <br /> , ►p, TYPE OF fll(TURE OP�ITEM FEE NO. TYPE OF EOU�PMENT FEE <br /> � WATER CLOSET(TOILET) � A/C—/VHNOLG UNITS—H.P. � <br /> �! BATHTUB FORCED AIR SY51 EMS—B.7.U. M E.A. ; <br /> UVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> ESHOWER CIOTHES DRYERS ' <br /> �j KITCNEN SINK 8 DISP VENTIUTION FAN i <br /> � CISHWASHER RANGE HOOD j <br /> LAUNDRV TPAV NIATER HEAi ER <br /> �� , WOODSTOVE � <br /> j CLOTHES WASHER � <br /> URINAL METAL FIREPLACE 6 CHIMNEY ' <br /> ORINKING FOUNTAIN FIREPLACE INSERT i <br /> FLOOA DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; 'L GAS PIPING � <br /> ROOP DRAINS—R.1INLEADERS � E%HAUST FAN ' _ <br /> '' SINK(SERVICE—FiAR,ETC.) <br /> � ' <br /> � <br /> � <br /> --�— <br /> � ' <br /> SUB TOTAL E ' SUB TOTAL S ' <br /> PERMIT $ � PERMIT S <br /> TOTAL FEE $ TOTAL FEE S S '(�V <br /> FRONTSETB�CK PEPRSETB�CY. SIOESEIBACN PLpNGHECKHUMBER fEE RECEIPTNO. <br /> useza+E �oTenen �ACANTSIiE FEES VALUATION FEE <br /> I I YES f I NO BUaoirvG ' <br /> TYPEOfGON57.�llOW�BIE 11RMCONSI.�CIU�L occun,xcv xodoWrtux6urms i <br /> 4BW° PLUMBING � <br /> i <br /> --�-r <br /> i <br /> 6REOFBLDO. NOOFSIolilES OnSEMEHi MECN�NIC�L �S � � <br /> I I YES I I NO ' '� <br /> i <br /> O�HER ' <br /> OCCIIP�NCYLO�D FlRESPNNKL[RSPEO'0 IIE1GMtUMIT�110N — <br /> i <br /> I I YES I I ND SI�IE BUILDING SURCHA(iGE ' <br /> � <br /> �--T— <br /> PE�bON FOA SPRINNLERS � <br /> STAiE ENERGV SUfiCHARGE � <br /> � <br /> APPUG�TION�CC.BY ruNsnrraoveoev CITYOFEVERETT PUBUCWOfiKS � <br /> LOCIIL SALES � <br /> TAX COUE IS 3105 TOTAL ' <br /> _ ., <br /> :}:}T•' 'rlc; ��, .. . . . . <br />