Laserfiche WebLink
r�f' <br /> "�`t- APPLICATIOQFOR CONSTRUCT�1 PERMIT eyerett <br /> c_:q;, <br /> j " y„E,�,p,�,,, TO BE COMPLETED IN IHK—PLEASE PRINT <br /> � everett HEATING SYSTEM: ❑GAS ❑ELECTRIC U ` <br /> BUILDING DEPARTMENT <br /> � 259-8810 / <br /> ❑ DEMOLITION I_1 COMBINATION i 1 BUILDING f_�MECHANICAL [.7PLUMBING ❑ SIGN <br /> . OVMER MAtL�DDFE55 CITY ZIP PHONE <br /> �1ar Stfa���r f51b I.�ek /�toreA�e Evcr�t-r 9$zol 2s2 - og� y <br /> TENANT MAIL�UDRESS CITY 21P PHONE <br /> � �RCMITECT OR DESIGNER M�IL�DOREdS QTY 21P PNONE <br /> � OENER�LCpITMGTOq M�M1�DURE55 CI1Y 21P PHONE UCENSEI <br /> MEp1ANIC/�LCONTP�CiOR MAR�DDRE55 CITY ZIP PNONE LIGENSE� <br /> ' /l�sr�fihW<si- I�ea����4 3116 /�'�1� kU� EUe�eft �yo � 2S`�5331 /JortticJMfo3�2Z <br /> RIMBMOCONTP�GTOR M ILAUDRE55 CITv ZIP PMONE LICENSE� <br /> � ClA6S OF WJRK <br /> � ❑ NEW [- I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVFJFRPL INSERT I_1 BUILDING RELOCATION <br /> G GONT�CT PERSON ANp PNONE NO. <br /> . CONIIUCTPRIGEOFWORN � �O� O <br /> DEBCRlE WOIiN�NO SOU�RE FOO7�GE 1NVOLVEO <br /> .zASfill Furu�ce ��F <br /> ' VROPOBEDU6EOFBUILDMO I HEREBY CEHTIFY THAT I HAVE READ AND EXAMINED THIS <br /> S � �1�e Fo M �I� ��017 e APPLICATION AND KNOW 7HE SAME TO BE TRUE AND CORRECT.AlL <br /> LEd4DE9C IPiqNOFPqOPERTY�SMOWNBELOWONARACNFWNCOFiES� PHOVISIONSOFLAWSANDORDINANCESGOVERNINaTHISTVPEOF <br /> WOViK WILL BE COMPLETED WITH WHETHEH SPECIFIED HEREIN OR <br /> �or eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO QIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> . OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CGNSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTV TO PERFOHM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SbN�TUREOFCONiP�CTOROR�U7HORI2E0�QENT O�TE �// �/�/ <br /> � <br /> ; RO1� x 7�. ,�j G-�.� <br /> I P /S ' �E�Q� MOI` e, - Jer�(--t- U �PP���NTSGITYBU NESSUCENSEN0.11NDBUSINESSN�ME <br /> j PLUM�INO MECMANICAL <br /> � N0. TYPE OF flI(TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> j WATER CLOSET(TOILET) � A/�/VHNDLO UNIT�H.p. , <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ' <br /> � <br /> � SHOWER � CLOTHES9RYERS � <br /> � KITCHEN SINK d DISP ; VENTILATION FAN � <br /> � <br /> � DISHWASHER — � RANGE HOOD � <br /> UUNDRV TRAV ; WATEH HEATER � <br /> j + CLOTHES WASHER � WOOD STOVE ; <br /> ; � URINAL ' METAL FIREPLACE 8 CHIMNEY i <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> �� { FLOOR DRAIN HEAT PUMP , <br /> i � BACKFLOW PREVENTERS ; GAS PIPING � <br /> , , ROOF ORAINS—RAINLEADERS � E%HAUST FAN , <br /> � � SINK(SERVICE--BAR,ETC.) � , <br /> , <br /> � � <br /> � . SUB TOTAL $ ; SUB TOTAL $ � <br /> PERMIT S � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ Gp � <br /> FOR OFFICE USE ONLY: <br /> FRONT6EiBl1CK REAPSETBACK SIOESETBnCN PUNGNECHNUMBER FEE REC'_' �NO. <br /> . U6EZONE �otnnen VnCRNTSITE FEES VALUATION FEE <br /> BUILOING ' <br /> � <br /> ttPEOfCOMiS.ALLOWAPIE lY1'FOfCON51.ACiVAL acurenn xndowtuiNGuxns <br /> �aM'� PLUMBING � <br /> � <br /> ----�— <br /> BLD(3. NOAf S10RIE5 enseMeqt MECHANICAI �" — <br /> i <br /> � <br /> OCCUPANLV LOAO FIPE SPRNKIERS REO9 HEIGHT I IMIUTION ADDITIONAL PLAN CHECK � <br /> i <br /> NEASON FOR SPRINKLERS O7HEfi ; <br /> � STATE BWLDING SURCHAHGE i <br /> Mi�NEOY VLANS�PPROVED9Y I:ITYOFEVEflETT pUBLICWOflKS i <br /> LOCAL SALES ' <br /> TN(CODE IS 3105 TOTAL �f� � <br /> � <br /> �` � • - ' � s. <br />