Laserfiche WebLink
i <br /> APPLIC. .TION FOR CONSTR�.CTION �' <br /> PERMIT ' <br /> �he everoreen eve�ett <br /> GTY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-88�0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER �� MAILAOORESS n' GItY ZIP /, PHONE <br /> TEN�NT <br /> ��MRILRODRESS� - ��� lilJS'�-t�_4�� L ��"`� T �JS—�G�I.Y� <br /> AqCHITECTONOESIGNER MAILAOOPE55 CI1Y ZIP PHONE <br /> GENEP�LLONTR�CTON MRILA�DRE55 CIIY ZIP PIIONE IICENSE• <br /> MECH�NIC�LCONTRRCTOR MAILADORESS NATI��� � EY�IPWGI���N'y' Z��� PIIONE LILENSE• <br /> I� INfILL <br /> —1.625-E.FdarinP virw„�--- Z�� ���Af�� �C�I D l�L <br /> PLUMBIN�CONtR�GTOR MRILP�UfiESS Fyeretl, WdSh.l�fl,g•tofl �YLOl <br /> , ___2�=GJYN1_—'____ ._"_—_____ <br /> CLASSOFN'ORN �,/. <br /> ❑ NEW ❑ AODITION 6Q ALTERATION ❑ �7EPAIF ❑ DEMOLITION ❑ WOODSTOVE/FR�L.INSERi ❑ BUILDINGRELOCATION <br /> . <br /> TEN�NT IMVROYEMENT ON IMENIOR REMOOE:ONLY GON14C1 PEI/15�0�N�ND PIION[NO. <br /> CONTRACTVeICEOFWORK J� ��_ _______.___ ___.__.___Q1`-�.. . . . R�NS__ <br /> DESCRIBEWORH�NDSOU�REfWt�GEINVUIVEU ��/� /. /1 <br /> �{.1-aX1Q�1td- (l�.�i 7���C.. C.�IY1C�-�i _— � � ��� � <br /> ,r�•r <br /> PROPOSED USE OF BUILDINO I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> i ! n �� KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> • L� ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br /> - �ec��oescnirr NOFPROPEPTY�SHGWNBELOWOfiATTRCMFOIIRGOFIE51 WHE7HERSPECIFIEDHEREINORNOL7HEGRANTINGOFAPERMITOOESNOT <br /> � PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> �Or e�ocK oF — ANYOTHERSTATEORLOCA:.IAWREGULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> � THISPROPERNTUPERFORMTHEWORKFUFiWHICHAPPLICATIONISMADE i <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 78.27 RCW AND � <br /> 296.200 WAC. I <br /> SiGNAtUREOFCON111ACtOROlI4UiMOPI.tED4GF.Ni OATE � <br /> �..v- a3,�.. ��..� �� x��;�_��___�,�-Q-�-' ���1� <br /> � PRQIECT�O�RESS_ pPP4CFNT$CIiV9U51NFS5LICENSENO.r1N00U51NE55N� �I <br /> LJ�%v/�Y\_�L� a �i � <br /> - ' <br /> � PLUMBING MECHANICAL � <br /> . NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> ' WATERCLOSET�TOILEn A/C—A/HNDLGUNITS—H.P. <br /> � BATHTUB FORCED AIR SVSTEMS—B.T.U.r15M.8k1 <br /> y��� <br /> . LAVATORY(WASHBASIN) UNITHEATERS—B.T,U. M <br /> ,� SHOWER CLOTHES DRYERS I <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD _ I <br /> - LAUNDRYTRAY I WATERHEATER <br /> � CLOTHESWASHER WOODSTOVE <br /> UFINAL METAL FIREPLACE 8 CHIMNEY __ <br /> DRINKING FOUNTAIN FIREPLACE INSEfiT _ <br /> FLOOR DRAIN HEAT PUMP _ <br /> � BACKFLOW PREVENTERS _ �_L GAS PIPING ��'_fQ[(.�LQ <br /> ROOF DRAINS—RAINLEADERS EXHAUS7 FAN ___ _ <br /> SINK(SERVICE—BAR,ETC.) � <br /> —— I <br /> — — I <br /> SUBTOTAL S _____SUBTOTAL _ % _� � <br /> ' PERMIT 5 _ PERMIT _ 8 /f <br /> TOTAL FEE $ TOTAL FEE S .�� — <br /> FRONTSET6AGR RE�RSELBACN SIDESEIO�CK PLANCHECMNUMBEO FEE NECEIPTNO. <br /> USE2uNe wrnnen vnC�m sne FEES VALUATION FEE �, <br /> 11 YES Il NO I <br /> BUILDING �� <br /> TYPEOFCONST. OCCUPANCYOf10UP NOAF�WEU.INGlINI1S ---- - — <br /> ���pWABLE/�CtU�L PLUMBING <br /> SREOFBIW. NOOFSIONES OSMC OCCLO�D MECHANICAL <br /> I 1 Y _ � <br /> I: N _ ___.______._"__ __.._—___ <br /> HEiG111lIMIlAf10N OTHER <br /> FlRESPPINKLERSilEOUIRED ❑VES ❑ NO $TATEBUiLDINGSURCHARGE <br /> STATE ENERGY SURCHAF7GE <br /> APPLICATIONRCG6Y PLRNSRPPR.BY PUBLICWORKS . <br /> roTa� �� <br /> I <br />