Laserfiche WebLink
t <br />� ^ <br />APPLICATIOI�. FOR CONSTRUCTI.�N PERMIT �Vefe�t <br />tlre Evergipen TO BE COMPLETED IN INK-PLEASE PRINT � <br />CI7Y OF <br />everett HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 \� <br />DEMOLITION COMBINATION BUILDING � MECHANICAL `+; PLUMBING SIGN <br />ONMEP MMLAD�PE55 qiV ZIP PHONE <br />�fz���� hl�chneJib 85a3 Xa�tic.a tJo,.� ��.e�c-tf' W!4 �18�(>R N- 3-8'��i�1 <br />� <br />TEN�NT MAIL ��ORE55 CITY ZIP PHONE <br />ARCHITEGTOi1DE5IGNER MAILAODNE55 CITV ZIP PHONE <br />GENERAL CONTRqCTOR MAII pDOPESS CITY ZIP PMONE �ICENSE � <br />MECHRNICAL CONTRRCTOq MqIL ADDRE55 CITY ZIP PMONE �ICENSE M <br />PLUMBING CONTRRCTOR <br />CLASS OF WORK <br />,�� NEW !.� ADDITION <br />II <br />GONTRACT PRICE OF WORK ' <br />OESCRIBE WORK �ND SOURRE FI <br />r <br />15� <br />PROPOSEDUSE BUILDING <br />�� <br />LEG�L DESCRIPTIDN OF PROPER <br />LOT BLOCK <br />ADURESS <br />PHONE <br />t <br />' ALTERATION ,�. REPAIR �� DEMOLITION ..�I WOODSTOVE/FRPL INSEHT .-i BUILDING RELOCATION <br />� CONIACTPERSONRNDPNONENO. <br />OF <br />TVPE OF FlXTURE OR f <br />WATEF CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACHF�OW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.1 <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />fRONTSETBACK REARSETBAGK <br />LOiAREA <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THF SAME TO BE TRUE AND COPRECT. ALL <br />FOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETE� WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PCqM1T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />- OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTAUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PP,OPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGN4TUREOFCONTRRCiORORAUTMORIZEDAGENT OATE <br />X . d <br />GONiSALLOWABIE iVP[OFCONSf.AG1UAl ocCuvexCr x0o�wfELLix6uxit5 <br />LNOOP <br />'BLDG NO.OFSTORIES BASEMENi <br />RNGYL04p FIRESPRNNLEPSRE00 HEIGMiLIMITATION <br />FEASONFOR <br />INTRKE BY <br />CITY OF EYERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TYPE OF EO' <br />A/C—NHNOLG UNITS– <br />FORCED AIR SYSTEM; <br />UNIT HEATERS—B.T.U. <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER ('j <br />WOOD STOVE <br />METAL FIREPLACE 8 C <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING �arn. � <br />EXHAUSTFAN <br />N0. nND�l�FESS NRME <br />M <br />SUB TOTAL S <br />PERMIT $ <br />TOTALFEE S <br />�] FEE RECEIPTNO. <br />J <br />BUILDING <br />PLUMBING <br />MECHANICl+L <br />ADDITIONAL PLAN CH[CK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WOFKS <br />TOTAL <br />