Laserfiche WebLink
APPLICATIO � FOR CONSTRIJ�`TI��N PERMIT everett <br /> uM F�rroim� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CI1 V OF <br /> everett f HEATING SYSTEM: ❑GAS U ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-6810 <br /> i i DEMOLITION I ', COMBINATION i I BUILDING I I MECHANICAL LI PLUMBING ❑ SI(3N <br /> ovmen Meii�oonEss arr zm v�ia+e <br /> i c� ke c � � �s/Fz ,��'Z,g y, � � �1 r G�U�u�l� u��� Ls'�v 8J-3° <br /> ifH�Ni M�nA0Df1E55 GIIY 21P i'110NE <br /> �I1�NI1ECiqIDE51GNER M�IL�DORE55 CI1Y IIP PMd1E <br /> GEHGR�ICONif1�C70R M�I�A�DRESS CIIV /Z��P PHONE J �n=LICENSE/ � '��/C <br /> o/o%1n,J /j1�,{j�/Jo�n, rG' �d'L�� /Y�/uy S��k�9 !ri /S�J.�I .�J�}.ry.1i/ite c�o /f .LJ <br /> MEGIIANIG�LCONIR�CTOR N�RIIUDRG55 CIIV ZIP PIIONE LILENSE/ <br /> RVMNMOCONiR�CIOfI M�IIADORE55 LIIY 21P PIqNE IICENSEI <br /> CUSS OF WONK �� � <br /> I I NEW I 1 ADDITIGN I 1 ALTERAiION I(:�f'7EPAIA I I DEMOUTION I 1 WOODSTOVE/FRPL INSENT ❑ BUILDIN6 RELOCATION <br /> /� cor�incT rEnsor+�No rrron1e rvo. / �J <br /> GIXITR�C7 PRILEOF WORIt '/ � OO �D�� C�LP��� U���2.a/ Z <br /> OLSGt1N1EWpIMANO50U�RE��,VT�GE1NVp.VE❑ � <br /> ,�'3/� liw.Onr/nyu.�(c� tsv��r,• !C'er�� e-c� <br /> raoroseouseovButi ^ I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �f� CCt.-�, APPLICATION AND KNOW TF�E SAME TO BE TRUE AND CORRECT.AlL <br /> IEGQDESCNI TIONOF PPp'ENTY ISIIOWN�ELOW OR�iIACHfWRCOPIES) PROVISIONS OF LAWS AND ORDINANCES 60VERNIN6 THIS TVPE OF <br /> ior�� � ���' �e�ocK O �� ov c� NOT. THELGRA T�ING OF AD ERMITJDOESENOT PR'ESUME O 61VE <br /> �u�� ' / AUTHOHITY TO VIOLAiE OR CANCEL THE PROVISIONS OF ANV <br /> 7"eM�a-� ��(J ' p �•-�. [� OTHER STATE OR LOCAL UW REOULATIN6 CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> A f� - O��' `• OWNER OF THIS PHOPERTY TO PERFORM THE WORK FOR WHICH <br /> /1��� aS�7-6 Z ���� �Q Z� � APPLICATION IS MAOE AND I COMPLV WITH THE STATE <br /> CONTRACTOFS lAW 18.27 RCW AND 296.200 WAC. <br /> SI6NATU OFCONTR�C NORAUTIIORRED/iOENT ��TE <br /> X ���-- <br /> -��� <br /> ��T�jzo 7-.e.Sn<ree v� ' �'�E�lF <br /> IC TSCIttBU5ME55LICENSENO.NMBUSM NNAE <br /> q,�s� HANIC�L <br /> Np. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WA?ER CLOSET(TOILEn � A/�NHNDLO UNITS-H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS-B.LU. M E.A. ' <br /> UVATORV(WASH BASIN) � UNIT HEATERS-B.T.U. M i <br /> SHOWER CLOTHES DRYERS ' <br /> KITCHEN SINK 6 DISP � VENTILATION FAN ' <br /> OISHWASHER � RANGE HOOD � <br /> UUNDRY TRAY � WATER HEATER ' <br /> CLOTHE3 WASIiER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOF ORAINS-RAINLEADEfiS � E%HAUST FAN � <br /> SINK(SERVICE-BAH,ETC.) � � <br /> � � <br /> , � <br /> � � <br /> � � <br /> � � <br /> SUB TOTAL S ' SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTAIFEE E ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�GN RE�f15[IOACK SIOESElOACK PUNCNELRNUMBEIi FEF. RECEIFTHO. <br /> use xa+e �oi nnen wcnN�sn[ FEES VALUATION FEE <br /> OUILDING fo 3 ;ari <br /> IYI'[OfGONIS.ALLOWML[ lYl'FOfCON51.PG1VAL aamextr 1rodDwtwncuxn3 — i <br /> tnan p�UMBING i <br /> --T <br /> SizEOFBIIXI. NOAFstoni[S Bns[M[Nr MEGIANICAL ' <br /> i <br /> (N;CUPANCV LOAf/ FIRE SVRNNLERS REOD NEIG111 LIu11nTION ADDITIONAL PLAN CNECK � i � <br /> i <br /> OTHER ' <br /> nrnsON ron SrqINNIERs <br /> STATE BUILDING SUfiCHARGE i S <br /> i <br /> wrnKeav rinesnrrnoceoov CITYOFEVERETT rueucwonks ; <br /> ��� LOCAL SALES � p� � <br /> TAl(COOE IS 3105 TOTIIL p <br />