Laserfiche WebLink
pppLlC�-�ION FOR CONSTRl7CT10N <br /> FERMIT <br /> M�ErrryrNn everetl <br /> I CITYOF � <br /> � everett <br /> BUILDING DEPARTMENT <br /> 259�8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> �.HEq Au�L�DUHIss C��r z�r rHONE <br /> Qrn �7UT C(�A[UL�XRIP ------ <br /> TEN�NI M11L�DORC55 Cilr IIP PNONE <br /> �q�NrtECTOR�ESqNEA MML�OD�E55 CRY Z�� PIION[ <br /> pENER�LCONiP�GTOR M�IL�ODRESS G�IY . ZIP PIIONE UGENSE• <br /> �nc.� G�.sr <br /> �I[CM�N�G4COMTRhGTOR MA4�DDAE99 GIiY IIP FNONE LILEN9E� <br /> Fur� �rL�,�..f <N,►f1L "S��i� II»�c.-s �a,•��rr 4s�t�i---'zszsllq� �v-o�c -GS ►zi k7 ' <br /> pIUMNNOCONIH�CTON M�IL�DDPE55 PfY ZII' PIIONE UGENSE� <br /> CWOOf1VJRK � / --_--_----—__ <br /> ❑ NEW ❑ �DDITION W ALTERATION ❑ REPAIR ❑ DEMOLI110N ❑ WOO�SIOVE/fRPL.INSERT ❑ BUILOINGRELOCRTION <br /> 7[NIWIIMpPOVE4ENiOA1NiERIOR11FM0uqEIONLY CON1�LiPER5011�110P110N[NO <br /> wnrn�crrm�orwonK. 'T 3 WO.��� --.-----.- <br /> p(lLII�pE WORIt�ND 90U�RE fO01�OE INVOLVED <br /> ffi/l1:Q__ iro 1`/�.st Utci�� �OdJ 5/� 'L ----- <br /> Mu'oe[ouseoreuao�na �, tNEREBYCEF�TiFVTHAfIMAVEREADANOEXAMINEDTNISAPPLICATIONAND <br /> KNOW THE SAME TO BE TAUE AND COAAECT.ALL PNOVISIONS OF LAWS AND <br /> �Ew�o[scai�*wr��vrovEntt�sHowneeiowonen.G�rovnco�c?� — GRDINANCESGWERNINGTMISiVPEOFWORKWILLBECOMPLETEDWI7M <br /> W I/ETIIER SPECIFIED HEREIN OR NOT.TME OR�NTIN60FA PEIiM1T DOEB NOT <br /> PRESUME TO GIVE AUTHORITV TO VIOLATE OR C�NCEL TME PROVISIONS OF <br /> �p�__ e�oc• or AIJYOTHERSTATEOFLOCALLAWREOULATINOCANSTRUCiIONORTMEPEIF <br /> FORMRhCE OF CONSTRUCTION.THAT I AM AUiHOR�2ED BY TIiE OWNER OF <br /> TNIS PROPERTY TO PERFORM THE WORK FOR WHICM APPLICATION IS MADE <br /> _ AND I COMPLV WITH THE SiATE CONTRACTORS LMV 18.27 RCN� 11ND <br /> 296.100 WAC. <br /> S�GN�1V�[OfLOHIR�GIO�O11AV111URKED�GENI D�tE <br /> X �,....w�c�( ��,�' � -i 2 - ef <br /> PIIdOJEGT�ODPESS e��LICANIS CII Y BUSINE55I.�CENSE NO�NO BU?�NE55 NeME <br /> J72� <br /> ����NQ MECHANICIIL <br /> ►p, t7P[OF fl%TU11E OII ITEM FEE NO. TYPE Of EOUIPMENT fEE <br /> WATEH CLUSET ROILEI) NC-NHNDLG UNITS-H.P. <br /> BATMTUB FORCED RIR SYSTEMS-B.T.U. M EA <br /> LAVATORV(WASHBASIM UNITHEATERS-BT.U. M <br /> BHOWER CLOTHESDRVERS <br /> KITCHEN SINK6 DISP. VENTILATION FAN <br /> D18HWASMER RANGE HOOD <br /> LAUNDPYTRAY WATEfiHEATEH <br /> CLOTMES W�SHER __ W�D STOVE <br /> URINAL METAL FIREPLACE 8 CH�MNEY <br /> DpINKIN�FOUNTAIN FIREPLACE INSERT _ <br /> FLOOR DRAIN NEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOFDR�IN3-RIIINLEADEFS _ E%NAUSTFf.N <br /> SINK(9EHVICE-BAR ETGI <br /> SUBiOTAL E SUBTOTAL S <br /> , PERMIT E PERMIT E <br /> ' TOTAL FEE S TOTAL FEE s <br /> '� FRONTSEIBI�Ck RE�RSETB�CR SiDEL[IB�Gn PtAMCNELRNUMBER FEE 11ECEIRMO. <br /> veeioNe wT�Ae� V�C�MSIIE FEES VALUATION FEE <br /> ❑YES O NO � <br /> BUILDING <br /> ryPEpFCON9T. OCCUP�NCYGROUP NOOFOWELlIN0UNi1S — — <br /> •L.LOW�BLF/�Giu�l PLUMBING <br /> SREOFBLUO. NOOI6iORlE9 BSMC OGCLOAp MECHANICAL <br /> ur <br /> uH <br /> uE�o�nuMiunon OTHER <br /> iIRE8M1iNNlER5PE0U�AE� ❑Y[S ❑NO STATE BUILDING SURCHARGE _ <br /> STATE ENERGV SURCHARGE <br /> il 11PPLIG�LION�GC BY VL�NSAPPR BY PUBUC WORKS <br /> TOTAL <br /> I <br /> + r-r+•... . . .. ' � � ` � <br />