Laserfiche WebLink
.-� � <br /> APPLICATIt�.N FOR CONSTRUC`� �ON PERMIT everett <br /> �Erere�� TO BE COMPLETED IN INK—PLEASE aRINT � <br /> CITV OF <br /> everett HEATING SYSTEM: ❑GAS ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �DEMOLITION ❑ �OMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PI.UMBING ❑ SIGN <br /> WNER MAILADDRESS CRY ZIP PNONE <br /> �oC�rzTG , �.oa�p� �2�- 1�+��.N� vU1A�.y�viuti ��z�u �5'S �8'!y cs5-i�wy <br /> TENANT M�ILADDRE55 CITV ZIP PMONE T- <br /> NdN� <br /> �RCHITECT OR DESIGNER MAIL ADDRESS C�TY ZiP PXONE <br /> bw N�= IZ- 59^•v►t- ' �� �r1r� <br /> 6ENEfULCONTRACTOR MAILAD�RE55 CITV ZIP P110NE I�NS�� <br /> N,��p, C'�►asTr�.��ivt,l2��iZ �l(d�-A�IDAIJE EUEI�! �j$2ol NA•►-B-A�Z3�H <br /> MECHM11G1LCONTRACTOR MAIL�DDRE55 CITV ZIP PHONE LICENSE� <br /> VNK1.(OW �I <br /> '� PLUMBIN6CONTR�CTOR MAI�ADDRESS CITV 7.IP PMONE LICENSEI <br /> � <br /> �i - � CtASSOFViOHI( <br /> � ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR EMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> � ��� CANTACT PEfl50N AND PHONE NO. <br /> � CONTqACT PRICE OF WORK L � <br /> � � '. DESCRIBE WCFK AND SOUARE FOOTAGE INVOL�A <br /> U C 7 1 � �^Z. <br /> � o�1 2--- � � � . T— a S?- 7YS-v <br />. � �. . � ���. raorosEouseoFeuaowo .,�^^ � r,,. � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> II� �� � �. SI PJG L� �/�v•1 I(��I I�7 I ��� APP�ICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> I�?"� LEdLL DESGRIPTION OF P OPEATV ISNOWN BELOW OH ATT�CH FWR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVER4ING THIS TYPE OF <br /> I. . WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />; 1 �o L 3`�e�aK � oF � NO7. THE GRANTING OF A PERMIT DOES NOT P^cSUME TO GIVE <br />� .j�,'r��-�� � � AUTHORITY TO VIOLATE OR CANCEL THE PRJVISIONS OF ANV <br />� ,,;. ,;=:�;,',.,. ��. OTHER STATE OR LOCAL LAW REGUUITING CONS'fRUCTION OR THE <br />� ,,,,,: .�,.. . PERFORMANCE OF CONSTRIICTION.THAT I AM AUTHORI2ED BY THE <br />` ! OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />� A v �� APPLIC O IS MADE AND I COMPLY WITH THE STATE <br />� '(� CONT CTOR LAW 1827 RCW AND 296200 W C. <br /> i t ts � SIGNA E OF C MCTOR OR A I GENT D <br /> t � > . <br /> A �1 y <br />� � f'���.,;:. A <br />� r� <br /> � ..,} , — <br /> w PRQIECTADOPE55 <br /> / � ' n 1 � 11P CITYBUSINESSLIC ISENO.IWDBUSINESSNA E <br /> L r• <br /> x• PLUMBINO MECHANICAL <br />� �. � NO. TVPE OF FlXTURE OR ITEM FEE N0. TYPE OP EOUIPMENT FEE <br /> �. WATER CL0.SET(TOILEn � AIC�NHNDLG UNITS—H.P. � <br /> � - BATHTUB ; FORCED AIF SYSTEMS—B.L!J. M E.A. ' <br />. - , ' LAVATORY(WASH BASIN)� � UNIT HEATERS—B.T.U. M � I <br /> � SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTIUITION FAN I � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACe S CHIMNEY ' <br /> DRINKING FOUNTAIN _� FIHEPLACE INSERT _� <br /> FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ��� ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> � SINK(SERVICE—BAR,ETC.) � � <br /> � � <br /> , i <br /> , i <br /> , �_ <br /> , , <br /> '� SUB TOTAL $ ; SUB TOTAL S ' <br /> � �. PERMIT $ —r- PERMIT S -r <br /> �' TOTALFEE $ ' TOTALFEE $ ' <br /> FOR OFFlCE USE ONLY: � 3� <br /> � � FRONT TI3ACK flEARSETBACK SIDESETB/'CK PLWCHECKNUMBER FEE RECEIPTNO. <br /> �. �0 2o S � 2 �a 1 3•3� a <br /> � p�2 LOT�REA M[ VACANTSAITE FEES VALUATION FEE <br /> � � % "` BUILDINC , 6 Z•GD I�SS $ O ' L <br /> lYPEOFCONPu'.ALLOWRBLE IYPFOFLONST.RCTUAL occuvaNtr rworoWEwNeuxirs � <br /> GRWP / p�UMBING 3S i <br /> �� I <br /> SQE BLDG. NO.OFSRIRIES BASEMENT MECHANICAL � <br /> J�EMs06L '� Z � <br /> S ADDITIONAL PLAN CHECK i <br /> OCCUPANCVLWD FIRESPRNKLERSREO'� NEIGHTLIMITfTIIXJ <br /> La ' <br /> Np � OTHER �_ <br /> RE�SONF �RSPflINKLERS C <br /> STATE BUILOING SURCHARGE �7 <br /> INTAKEBV PLANSAPP OVEDBY CITYOFEYEREIT PUBLICWORKS i <br /> � LOCAL SALES � <br /> s�q TAX CODE IS 3105 TOTAL � ; Z � <br />