Laserfiche WebLink
. . <br /> APPLICATIC"`1 FOR CONSTRUCT'�lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PJ.EASE-PRII� <br /> � <br /> BUILDING DEPARTMENT H. ":ING SYSTEM: J AS � ELECTRIG%J�= _ <br /> �� <br /> 2Ci9-8870 <br /> DEMOLITION �OMBINATION BUILDIrIG I MECHANICAL ;PLUMBING � i SIGN <br /> O ER � M�ILAD�iiE55 CITV ZIP PHONE <br /> .a✓�'o� v�svn �/7/U/�u�La� �r G"r�r�I`�' `1Si�c�� �ciG� �5-3 --5'S�C� <br /> TENANT MAR ADpPE55 QTY ZIP PNONE <br /> 5�,.,� <br /> ARCHIT�CTORpES�aNER MRILADOiiE55 CIT1' 2iP PHONE <br /> �'n� /9'i5- ��.�i's•%-i Gv�'�-�-�f- 9fr�ru� ��o�G) 3s3 —Gr3/ <br /> GENER/AL O�NiRACTOR MAIL ADDRE55 CITY 21P PHONE STATE LICENSE� <br /> � f1aPl�ac � (�on5f /S�.�G 39�.Av�Nr-. 57o�wo-ac� 95'.19� �9GO.�itJ-SYr16 S<Llo�t-��6GL/� <br /> MEGMANICAI GONiRACTOR MAiL ADDRESS CITY ZIP PNONE SiATE LICENSE� <br /> PLUMBING CdJTRACTOR MAIL AO�RE55 CITY ZIP PHONE STATE IICENSE� <br /> CONTRACT PRICE OF WORH <br /> ��,OOC� <br /> DESC IBEWC�IKANDSOUARF�fOOiAUEINVOtVE CONiACiPEP50NaNDPMONjNO. <br /> — '1 C t' `._.l ci/[�d�� <br /> � 31 _r' .�� �.�rt L,• ,� a �7/rh. �60 � �.ssf�6 <br /> aU !r 4� if"' � � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO E OF BUiLOMfi / qpPLICATION AND KNCW 1NE SAME TO 8E TRUE AND COHRECL P.LL <br /> M.I fi—�P'um��I•/ �eS�clPn c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> L[GRLOESCRIPTIONOFP OPERTY�SHOWNBELOWO rrncNnvocoFies WORK WILL EE COMPLE'ED WITH WHETHER SPECIFIED HEREIN OR <br /> � NOT. THE GFANTING OF A PERMIT DOES NOT PqESUME TO GIVE <br /> �ot ¢" e�ocK-- oF � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �����y PERFORA7ANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> �` 95 0ya7- � OWNER OF THIS PROPERTV TO PEFFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> vnecei rn�a,,i�o.�rvuMeea ��� 5{�o�Y CONTRACTORS LAW 18.27 W AND 296200 WAC. <br /> CONSTRUCTONLOANOENDER.A00 E55.'�1 PHONENU1dB�9Sa� —�� <br /> �/o.,L � �� 5 /5= 9'S._ <br /> P O CT DRESS G s�c f5 3G5-- o�ie <br /> qr � ` , (.(/(� CILVBOSMESSI�LiN5fN0 <br /> PLUMBING MECNANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> p WATER CLOSET(TOILET) // �/ �/.�, � ArC—NHNDLG UNITS—H.P. I <br /> p BATIITUB /i / �7 ; FORCED rIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � //,�/ UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DRYERS <br /> KITCHEN SINK&DISP G VENTILATION FAN <br /> DISHWASHER G RANGF'�OOD <br /> LAUNDRYTRAV � WATERIIEATER <br /> CLOTHES WASHER WOOD STOVE <br /> l'R!NAL ETAL FIREPLACE�W00B'DVRIV11GGj- <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FIOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENiERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) I � <br /> � <br /> 1 <br /> SUB TOTAL $ / .j� ' `�� SUB TOTAL $ <br /> PERId1T $ O G� � ` PERMIT $ <br /> TOTAL FEE $ �`� TOTAI FEE 5 /3G' � � <br /> FOR OFFICE USE ONLY: G' ��� <br /> FqOI1T5ET8A K R[ARSEIFI�CK SIOESEIBALK PLANCNE N UMpER FEE p R@CEIPiNO <br /> �5 Zp� a25� S � ����� �39/� <br /> use zoNe ior aaen V�CFNT SITE FEES VALUATION FEE <br /> .z Z 2, 6Zz �ES - No BUILDING /q g 339 ���'��� �r <br /> TYPEOfCONSi NJAFSTORiES o(Cuonxcr rvOo��WEwrvcurvns � <br /> �_'J "a''3 '� PLUMBING � ; <br /> SIZEOFyBLDG F SPRIYKLERSP '0 BASEMENT � � MELHANICAL _ <br /> 2�'�$ SGRIRn4c G .-- YES �✓NO � <br /> sw � ; �, <br /> OCCUPANGYLOnD F �o�c NEIGi�TUMiraT10N �DDITIONO..PLANCHECK <br /> � � <br /> N OTHER � <br /> REASON <br /> S1ATE BUILDING SURCNAPGE <br /> INTAKEBV PLFNSAPPROVEDBY CITYOFEVERETT PUBLICWORKS `Cli '� <br /> LOCAL SALES /'/ . <br /> DATE TAX CODE IS 3105 TOTAL y ; <br />