Laserfiche WebLink
.,y,q /..._. <br /> APP�.ICA. ION FOR CONSTRU.�410N <br /> PERMeT <br /> No Evergreen <br /> � � CITYOF everetl <br /> ��y ev�rett � <br /> � � - BUILDING DEPARTMENT <br /> � y y . 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNEfl MFILT�ORESS CIiY ZiP PNONE <br /> � � � j��1i� ,�, ,� s�os^ �.��Y '�r1 rUr=.,�,� q�va�_�_—� �� -r.�,��� <br /> ��� F ANi � �L� MAILAD��E55- .. CIIY� 21P PMONE�,�,__��._"'_-_._... <br /> y aRCNITEGTOROESIGNER ��/ILAOORESS CItY ZIV PMONE <br /> � xo ,p /v "G Gf�/V�f},�5����q R;lLC-'�$i� i� �= S I/IN1?R `1�3� SG.�-S'aoo �J/,a <br /> �]� ENE ALCONTRRG N MAILAD E 5 CIiY ZIP PHONE LICENSE+ <br /> d A' /�/ /'` I' I ' '` �J <br /> l�I � V ` EGH!G�C/NifCTOR�n'VC/ �'/VIMFIL` ��� ��YI/1/ %V !�'l�Z���2o? 3�f?"���� �V�E . � l�l�� <br /> �r n <br /> x y� PLUMBINGGONiRACTOR MAILpODRE55 CITY ZIP PMONE LIGENSE+ <br /> E <br /> HH <br /> �y y cv.ssorwoaK <br /> NEW ❑ ADDITION ❑ ALTERATION REPAIR L7 DEh10LI710N ❑ WOODSTOVE/FRP�INSEPT ❑ BCILOING REIOCPTION <br /> H <br /> ��y TENR4TIMPPJVEMENiORINTER10RREMODELONL�r. O/� � //� CONTACiPLR50NANCPMONENO <br /> S� � <br /> � GONiRACiPPIGEqiWORK v/��!z��s..sn../�T/I �.�---. <br /> y O y DESGHIBEWORKAA9SOUAFEFOOTPGEINVOLVEO • � � <br /> v oPo USeoFeuito,`�G ` '�^ � IHEREBVCERTIFYTHAT.�IINEREADF.NDE%AMINEDTHISAPPUCATIONAND <br /> YQD ��,•`-p�y� NNOWTHES�METOBETRUEANDCOFRECT.ALLFROVISIONSOFLAINSAND <br /> �� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br /> i.Er,n�oescamrion FPNCPEPttISHOKNBEIOWOFATiACHFOORGOPIE51 WHETHERSPECIFIEDHEREINOHNOT.THEGFANTINGOFAPEfiMITDOESNOT <br /> ����� PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION$OF <br /> �oT� B�oCrc__ �F f�F._N�.� 'dLVLl' ANYOTHERSTATSORLOCALLAWREGULATINGCONSTRUCTIONOFTHEPER� <br /> FORMANCE OF LONSTRUGTION.THAT I AM AUTHOqIZFO BV THE OWNER OF <br /> ftCC_�IR/I/W� I O I N/� VLAIy �TI� ' = THISPROPERTVTOPFRFORMTHEWORKFOHWHICHAPPUCA710NISMADE <br /> � AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCN' AND <br /> I (� ^A� 29fi200 WAC. <br /> t��^„LnRDi h �N daLuMF u•� �F /�mr� SIGNAiUREOFCONLflALiOFOFAUiHORIZEOAGENT �Ai[ <br /> �35�-7 3G r?r=�RDS a � S/vnrfnrv;,TR tGs, jX����,����t��/ �r <br /> PROJECTA�DRE55 pp q SCITYDUSMESSLIC[NSEN9.AN OolE55 <br /> PLUMBING MECNANICAL <br /> " NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPt OF E�UIPMEN7 FEE <br /> ' ' WA7ERCLOSET�TOILET) — -� NC—fVHNDLu'UNITS—H.P. <br /> � � BATHTUB FORCED AIR SYSTEMS—B.T.U. M EA <br /> '�t LAVATORY�WASHBASIN) - � UNITHEATERS—B.T.U. M <br /> SHOWER CLOTHESDRYERS <br /> ' ' KITCHEN SINK 8 DISP. '� _ VENTILATION FAN <br /> � DISHWASHER � , RANGE HOOD <br /> ' �_ LAUNDRYTRAY _ r _ � WATERHEATER <br /> CLOTHESVJASHER --^ WOODSTOVE <br /> ' URINAL — METAL FIREPLACEB CHIMNEY <br /> --�-- ORINKING FOUNTAIN � FIREPLACE INSEPT � <br /> '� ^ FLOOR ORAIN HEAT PUMP <br /> ; — BACKFLOW PREVEN7ER5 _ — GAS?IPING <br /> _ ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> ' SINK(SERVICE—BAR,E7G) — <br /> �' <br /> �' — <br /> � <br /> i�j SUBTOTAL S — SU6TOTAL 5 J <br /> � PERMIT 5 PERMIT S <br /> � TOTAL FEE 5 ) � TOTAL FEE 5 J <br /> FROMSETBACK FEARSETBI.CN SIO�SETBACK � PLAN ' E NNUMBEfl fEE AELEIP�NO. <br /> _�� 25 � .S � c t �� � �J�� � 7 <br /> ueE2oHE LOTPPEA vnCnNrare FEES VALUATION FEE <br /> `��� �YES ❑ NO — <br /> !\ nl,�� <br /> BUILDING � <br /> TYPEOFCOYST. ' OGLUPANCYGPOUP NOOfOWELLINGIlNIiS /� - <br /> auo•.w:o��nCtua,/�N !9 ,,, J � PLUMBING ��l �� <br /> �" K <br /> 512E OF BLOG NO.OF STOFIES BSM[ OCC LOAO I I .G'` C� � <br /> � S r � ry y ���1 MECHANICAL i � , , <br /> r r� o� �-I� <br /> dEiG�rtumrtnncH OTHER ; <br /> I3�'S SF �I:�AGE � ---- <br /> FIRE PRINNLEPSREOUIPEO ❑YES o STATE BUILDING SUFCHARGE ' <br /> STATEENERGYSURCHARGE � � <br /> pPPIICAiIONAC DI PLNNSAPGRBV ; <br /> i PUBLIC WORKS <br /> . �'�'� ' / <br /> � _ " TOTAL <br />