Laserfiche WebLink
APPL�CAYi� N FOR CO�l�"t'RU�'.�ON PER!.�IT <'��'�`'" <br /> rnae�er9i�:r�� TO BE COMPLETED IN WK—PLEASE PRINT � <br /> CIIY OI' <br /> everett - --- -- -- --— <br /> �HEATING SYSTEM: ❑GAS J ELECTRIC IJ__.__ _.__ __._ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITiOPI yg COMBINATION RUILDING MECHANICAL _ PLUMBING SIGN <br /> OW/NER hNRA0DRE55 (-�. 2iP �'HOt�E <br /> � (�-rG/�l Ei'—LO �� (� . ���1*`_ �•% ��tF117GC `/�%C3 .S�/%` �f:l �i __ . <br /> lEtIANT RIAILADORE55 GITY ZII' PMONE <br /> � � — <br /> ARC��rtEGTOFOESIGNA �dAILF�DRE55 GITY ZIP PHONE <br /> I ( <br /> y��i G[NERnLCONiRPCiOR MAtLFDDRE55 CIiY ZIP PHONE LIG[RS[� ' <br /> �h'� 1 , i Ev�lF_ I:K-x I`I3�J' <br /> 9a ciTv z,a r>uo,�� ucervsee <br /> �"�H MECHANIGALCONTRACTOR 1AAILFpDRE55 <br /> C :�^- IDL'�G(1�izT '�ILONlA `iF��/�^r�ti'L��'N 1�C J� <br /> aycn �Ncr2GS' �'Ec[.an-r 5 �-I �.K <br /> � �� PWM�INGCONTRA;'�JR 4M!pOpflE55 C�iV ZiP PNONE �ICENSE+ <br /> � z� (/F_�'Fc('-l��/y�iC - �'�cl��� l�ING ��C 21�� p Lyi�l�rwc o�� �rSC'3L (�LRF PC jKl3�� � <br /> H x1 <br /> CLASS OF P�ORN <br /> � H� �C NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE�FRPL INSERT . BUILDING RELOCATION <br /> y y� �r,qiACT PERSCK M1D PMONB NO <br /> � O$ CCLiRACTPRiGEOFWORK ��QjL. t� vt i<i/ /—� �C..^�l L ,_ <br /> tt� DESCAi�EWORKAND50U/+REFOOTAGEINVOIVED � ,)/C. <br /> H t7 <br /> O H �/[:W CC�/Si"QUCT7D�i "�_/IG� — <br />� H �g r;+or�oseouseoveuaowc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED �iS <br /> �" n (��}IP)�r/T/AL APPUCATION AND KNOW THE SAIdE TO 6E TRUE AND CORRECL ALL <br />� H PROVISIONS OF LAWS AND OROtNANCES GOVERNWG THIS TYPE OF <br /> z y� �.!,n�oeswianouocvnoPeenur+owuoe�owoua�mcui�a;nr.c.��.e;� WORK WILL �E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> : ��y-� ���� <br /> X ior� '���� a` �L.:i—c+-r�L��` NOT. THE GRANTWG OF A PEPMIT DOES NOT PfiESUME TO GiVE <br /> H H AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> g �N C�CG-}^�— 2�-r��r '�j OTHER STATE OR LOCAL lAW REGULATING CONSTRVCTION OR THE <br /> �E PERPORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZC"BY THE <br /> Cy ,C�� -- OWNER OF THIS PROPERTY TO PERFORM THE WOt3K FOR :":{IICI I <br /> � �� AFPLICATION IS MP,DE AND I COMPLY WITH THE STATE <br /> : <br /> y y y CONTFiACTORS LAW 18.27 RCW AND 296200 WAC. <br /> I-3Q(A SIGNait1R[OFrGliqACi RORAUiHDAREOAGENt U-0iE <br /> � 21��(2 ti����� <br /> -- — ------- ------ - X E' �'� !��lr�= <br /> Fno��ecrnooauss - — <br /> +. �,rv_nliSOivUUSir�E55LiGENSEr.pnN�BUSiNE55NAME <br /> PLUMOING MECHANICAL <br /> NO. TYPE OF FI%TUfiE OF ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �s A�C—A�HNDLG UNITS—H.P. <br /> 3 WATEF CLOSET(TOILGT� ___/I_ ' <br />� !! /��— BATHTUB � }` ; � FORCED AIR SiS7EMS—B.T.U. M EA. _ . <br /> LAVATORY�WASHBASIN) __l��__ UNITHEATERS—B.T.U. h1 <br /> P.e. � � SHOWER —' � CLOTHES DRYERS _ _ <br /> � �_ KITCHEN SINK 8 DISP �� _� VENTILATION FAN <br /> r S� �ISHWASHER _ RANGE HOOC___ <br />� LAUNDRY TRAY ^' __'_, WATER HEATER <br /> CLOTHES WASHER WOOD S�OVE <br /> �"'� URINAL � _METAL FIREPLACE&CHIIdNEY <br /> �RINKING FOUNTAIN ` FIREPLACE INSERT �Jil i — <br /> �.� FLOOR DRAIN HEAT PUMP <br /> , � BACKFLOWPREVENTtRS ; ( GASPIPING <br /> ROOFDRAINS—RAWLEADERS —�— EnHAUSTFAN _ _ <br />, SINK(SERVICE—BAR.ETC.; � , �— <br /> � i____ <br /> � ' _ �.� A�_—t �—'•-�^-Y--.•-,�i )acC J'L lr O � <br /> 6— o <br />. —— — -- ---i— <br /> ��i s <br /> O I SUB TOTAL S $`� � " SUB TOTAL 3 �Jo � � <br /> PERMIT 5 FERMIT S <br />' TOTALfEE 5 S- � — TOTALFEE S 9e ; "� <br /> ' FOR OFFICE USE ONLY: <br /> Ffi06T5EIDACK f1EANSF.1flACN � SI�ESE1dACK �'LANCHECnNOLI[ICF �[E REfclPTNO <br /> � � d� , S / �>/ < c: , , , Jns;c. vs t s�o <br />� use zor+E irir neen vncnr+r sn� FEES VALUATION FEET_ <br />� iQ' r 3�3 aui�oiwc 7'� yciy 5"d1; .57+ <br /> r- — <br /> iYPL04G�NI5AllOWAALE IYPFOfCONSiACIOAL �xcu�u;;v ap0�cnu�+iGi�'���5 �LUIdBING � <br /> ��-:.,� �5; — <br /> ✓ 'd V_ '� — �3 � — <br /> 5¢e C'aLRG. rv0 oF SroniEs oASEu[Nr MECNANICAL 50 <br /> /C ZL 3/- � � � — <br /> YLoTF �Q _ <br /> OCCUPANGVLOA FIRESPRNKLEFSREO'D ��EiGMTIICInNION ADDITIONALPLANGH[CK <br /> I � � �_� OTHER <br /> I REFSONFCRSVNNNL[RS --T <br /> STATE 6UILDING SURCHARG[ _ y ! S Z , <br /> wrnrceer r�n��snPrnoveonv CITY OF EVERETT PUBLiC WORNS c7�tJ I� � <br /> LOCALSALES <br /> J�f TAX CODE IS 3105 TOTAL 7 a-�2 j Od <br />