Laserfiche WebLink
� "�l � <br />� APPLICATI�N FOR CONSTRUC�ON PERMIT <br />I thB Evergreen <br />' everett <br />j BUILUING DEPARTMENT <br />', 259-8810 TO BE COMPLETED IN <br />O DEMOLITION fJ COMBINATION ❑ BUILDING <br />�i O N�^E^P ; MqILA� DD�E� �D �.=� <br />•I` � <br />TE T MAILAD�flE55 CIIY <br />AflGHITECTOR0E510NEH MAILADDRESS CITY <br />� <br />! <br />� PLUMBINGCONTPACIOR MRIL�OORE55 CI7Y <br />� cussoFwoaK <br />� (-I NEW I 1 ADDITIO � ERATION I I REPAIP. I� I DEMOLITION I I WOODSTOVE/FRPL INSEFiT I 1 BUILDING RELOCATION <br />PRINT <br />nr <br />Cl PLUMBING <br />- 55(� <br />i <br />everett <br />e <br />❑ SIGN II, <br />ZIP PIIONE LICENSE � <br />�-��'«�'1.) <br />TENANTIMPROVEMENiOR <br />CONTMCT PPICE OF WOflI <br />LE� <br />LOT <br />� PRQIECTAODFE55 <br />PLUMBINO <br />NO. <br />BLOCN <br />', WATER CLOSET (TOIL <br />' BATHTUB <br />LAVATORY(WASH BA; <br />SHOWER <br />� KITCHEN SiNK & DISP <br />; DISHWASHER <br />I UIUNDRYTRAY <br />a <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENI <br />ROOF DRAINS—RAIN <br />SINK (SERVICE—BAR <br />BEI OW OR AttACH FOUR COPIES) <br />OF <br />OR <br />CONf4CT PEe50N �ND PNONE NO, <br />i HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS � <br />APPLICATION AND K�OW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS (iND ORDINANCES GOVERNING THIS T`/PE OF �� <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR i <br />NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TC GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ' <br />OTHER STATE OFl LOCAL LAW flEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE '. <br />OWNER OF THIS PROPERTY TO PERFORM THE W�ORK FOR WHICH . <br />APPLICATION IS MADE AND i COMPLY WITH THE STATE ��. <br />CONTRACTORS I.AW 18.27 RCW AND 296.200 WAC. I <br />SIGNATUPEOFCONIRACIOPORAUTHORI2EDr1GENT UATE I <br />1 _%�.. <br />APPLICpNi$ G!Y <br />BUSINEGS NAME <br />MECHANICAL <br />FEE NO. TYPE OF E�UIPMENT <br />� AIC—NHNDLG UNIT£,—H.P. <br />; FORCED AIR SYSTEMS—B.T. . <br />� UNIT HEATERS—B.T.U. M <br />~— CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PEFMIT S � <br />TOTAL FEE $ ' <br />' FHONTSETBPCK REARSETBRCK SIOESETBACN PLANCHECNNlIM9Efl <br />� USEZONE LOTAflEA VACANTSITE FEES <br />❑ YES ❑ NO BUILDING <br />� TYPEOFCONSLALIOWABLE iVPEOFCONST.RCiOAL �tUreN[Y Nv.aowElliNcuxiR <br />. °"0°v pLUM81NG <br />! SIZEOFBLDG. NO.OF3TORIES BASEMENT MECHANICAL <br />I7 YES ❑ No <br />� OCCUPANCVLOAD FIRESPflNRLER5RE0'0 HEIGHiIIMITATION OTHER <br />• CI YES ❑ NO STATE BUILDING SUfiCHARGE <br />� pEASONFORSPRINNLERS <br />� � STATEENERGYSURCHARGE <br />, APPLICATIONACC.BY PUNSRPPROVEDBV CITYOFEYEREiT PUBLICWOflKS <br />�aca� sa�es <br />� TAX CODEIS 3105 TOTA� <br />SU8 TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FEE RECEIPTNO. <br />: <br />FEE <br />� <br />