Laserfiche WebLink
APPLICATIt,..V FOR CONSTRUC7 �ON PERMIT � <br /> 1 <br /> �J - everett { <br /> ,n�.E.e�o��� _ ,��� �« ��:� �%�G �� _ ����� e . <br /> GITY OF <br /> everett ; <br /> BUILDING DEPARTMENT , <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br /> O {� MAIL PODRES ITY� J��� � ^O� ��0�����_��� � <br /> ��� l� TaQraN I1�0 We�nnRE � T zZ�_�L�4_ „ <br /> � o� <br /> IENANi �ELF M41LAOpRESS ����IiV�V� ZiP PIIONE <br /> M1CrIrtEGTOPDE5IGNER IAAILPO�R[55 GIiY IIP PNON[ . <br /> GLN[11ALCONTRNLT R MRILADDRE55 CITY ZIP PMONE LIGENSE• <br /> � �� CITV Z�P PNONE IICENS[• <br /> MEGNANIC�LCONiR GTOR MPiLR�ORESS <br /> y tm 2iP PHONE ULENSE• <br /> � '�7' VW�ABMGCONTR iOR MARPODPESS <br /> � H!HA <br /> CLASSOF WORK � <br /> ��� NEW �DDITION ALTERATION REP�IR DEMOLITION WOODSTOVErFRPL INSERT BUILDING RELOCATION <br /> y� IENANiIUPROVEMENTOli1NiERIORREMOOEL-01NLY� GONi TP[RSONANpPHON[�JO <br /> 1�M1� CONiNACTPRIC[OFWORN:W�K�ryG�!l�BYDy� L ���^� -�59-G�92 "e <br /> VJ H 0 SCRiBE WORK AND SOUARE FMiRG[IHVOL\'[D � �/ ('/ / �� <br /> �x� l�nu8�u�om �ll$-�'� `�if , r �_ <br /> < «. �, «, <br /> Qy � PROPOSEOUSEOFBOILDING I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �A ��M ,�� � (1 ( APPLICATION AND KNOW THE SAME TO 8E iRUE AND CORRECT.ALL <br /> N�� ri i��i_o PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 71'PE OF <br /> �ecn�uescaivrioHOFCAorEarvisNowr+eeiowonnrtncNwuacoricsi yyORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> 'n� n �or a�t a? otock aao oF N���►r�s�kor�e NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 9 H x OTNER STATE OR LOCAL LAW REGULAiING CONSTRUCTION OR THE <br /> � <br /> C� H y PERFORMANCE OF CONSTRUGTION.iHAT I AM AUTHORIZED BY 7H <br /> �y OWNER OF THIS PROPEFiTV TO PERFOi7M THE WORK FOR WHICH <br /> N <br /> O H APPLIC�TION IS E AND COMPLV WITH THE STATE ' <br /> �CCC�N CONTRACTORS W 1 .27 CW 296.200 WAC. <br /> �q �y 9GNAtUiiEOF�O PAC � O HO DAGEN� DPTE — <br /> r �� � <br /> y �� X <br /> � FRQIECT ADORE55 .�� <br /> /// APPIICANTS biV OUSiNE55 L 'FISE NO AND BlI51NE55 NAM[ <br /> PLUMBING MECHANICAL <br /> j NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � WATER CLOSET(TOILET) !�C—A�HIIDLG UNITS—H.P. <br /> �� BATHTUB FORCED/�IpSYSTEMS—B.TU. M E.A. <br /> LAVATOR'/(WASH BASIN) UNIT HE4TERS—B.T.U. M <br /> SHOWEF CLOT!1ES DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> I ��� �ISHWASHER RANGEHOOD <br /> �' LAUNDRYTRAV WATER HEATEF � <br /> CLOTHES WASNER WOOD S70VE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT _� <br /> � �� FLOOR DRAIN HEAT PUMP <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> ROOFDRAINS—RAINLEADERS E%HAUSTFAN <br /> 1� SINK(SERVICE—BAP,ETC.) <br /> �� <br /> `�� <br /> � SUBTOTAL 5 SUBTOTAL 5 <br /> PERMIT 5 PERMIT S <br /> � TOTALFEE 5 TOTALFEE 5 <br /> FRONi��yK REPRSEiv'N SIDES`E�ACN � � PLANCHEC �OIA ER � FEE / ^^ 7D RECEIP�O���� <br /> Z J , G/v ' <br /> 1 <br /> usezorv[ iornpen VACANTSRE FEES VALUATION FEE <br /> 6 . YES �. NO BUILOING ,�+ �}3�'(, _ 7. � � <br /> �YPfOiGONSLAIIOWABIk iYPEOfCON5i.I1L1U>l M[unriw n9rrtCxitl'v4uM1i�5 J�� <br /> tuouv � pLUMBING <br /> � ' �� �-�J 1 <br /> SR[OFB�DG NOAFSTORI[5 �AS[MENT MECHANICAL <br /> y'� r, ' � � YES �C NO 1 <br /> OCCUPANCVIOPD FIRESPRNKLERSRWD NEiGHiLiMrtALON OTHER <br /> I y�^ <br /> . �. YES ]�NO Z� STATEBUIL�INGSURCNARGE �'"�l <br /> RU N FOR SPRINRLERS <br /> STATEENERGVSUPCHARGE <br /> �PPLILPTION�CC.BY PUNSAPPROVED OY CITY OF EVERETT FUBLIC WORK$ <br /> �_ LOCALSALES .��<< � <br /> M�� � g TAX CODE IS 3105 Tora� _�� .� <br />