Laserfiche WebLink
� � � <br /> APPLICAYION FOR CONSTRV.:TION <br /> PERMIT <br /> the Evergroen everett ` <br /> CITY OF <br /> everett � <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> OWNER MAILR�OPE55 GiiV ZIP PMONE <br /> _`•___n� �L � <br /> TE �pNT' MAILAO�FES$ CIiY ZIP PMONE <br /> RRCHiTECTOROESIGNEF MAILADDRE55 GIiY ZiP PMONE <br /> GENEPALCONiRACTOR MAILAODRE55 CITY ZIP P�IONE JCENSE+ <br /> MECHANIGFLCONTPACTOR MAILAD�RE55 CIfY 21P p�MONE LIGENSEr <br /> PLUMBINOGGNTRACTOP MAILAODRESS � J QTY � 2iP PHONE LICENSE♦ <br /> - � �/S - � vf dt. � �e�y 9�s��6.�-i 4�a .�Na,�P.�¢icc <br /> CLASSOF WOPN <br /> �I NEW ❑ AD ITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSCRT ❑ BUIL�ING RELOCATIC�N <br /> IENRNT IMPPOVEMENT OR INTEHIOR REMODEI.ONLV CONiPCT PERSON AND PNONE NO. <br /> CANTFACT PflIGE OF WORk <br /> DESCRIBE WORN RNp SOUARE FOOTAOE INVOLVED <br /> - `T e-ti,� /��� <br /> aao SEOUSEOFBUIL�IN IHEREBYCERTIFY?HATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> i' � �,a �r �G� KNOWTHESAMETOBETaUEANDCORRECT.ALLPROVIS10NSOFLAWSAND <br /> LEQRLDESCRIPTIONOFVN PERtt�SNOWNBELOWORhTTACMFOIIRCOPI[5� ORDINANCESGOVERNINGTHIS7VPEOFWORKWILLBECOMPLETEDWITH <br /> WHETHEF SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> PRESIIME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �O7 eLOCK oF ANYOTHEiiSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> � FORMANCE OF CONSTFUCTION.THAT I AM AUTHGRIZED BV THE OWNER OF <br /> � THIS PROPERTY TO PERFOfiM THE WORK FGR WHICH APPLICATION IS MADE <br /> � AND I COMPLV WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br /> 296200 WAC. <br /> SIGNRTUFEOFCONTqRCTOROHAViHORIZEDAGENT DATE <br /> X , <br /> VROJEGTnODPE55 � ��� ������ ~ <br /> ��p G APPUCRNTSCITYBUSINESSLIC[NSENO.RND INESSNAME <br /> � � /^ \ S. G <br /> PLUAIBING MECHANICAL <br /> � NO. TYPE OF FI%TUHE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILE7) A/C—A/HNDLG UNITS—H P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M EA <br /> � LAVATORY�WASHBASIN) UNITHEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> � KITCHENSINKBDISP. VENTILATIONFAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDFV TRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLAGE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING i <br /> ROOF DRAINS—RAINLEADERS ExHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) I <br /> I <br /> � <br /> SUBTOTAL $ SUBTOTAL 3 � <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE $ TOTALFEE 5 <br /> FRONTSEfBr1GK PEARSETBAGN SIOESEfBACK PUNCHECNNUM9EN FEE NECEIPfNO. '�, <br /> USEZONE IOTAPEP VPCRNTSITE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> BUILDING <br /> TYPEOFCANST. OCWP�NCIGflOIIP NO.OFOWE�LINGU41T5 ' <br /> ALLOWRBLFJACTUAI '. <br /> PLUMBING <br /> SIZEOFBI�G. NO.OFSTORIES BSMi. OCGlOAD �'� <br /> ❑r MECHANICAL ��. <br /> ❑ N <br /> HEiGHT�IMITATION nTHER <br /> FIPESPqINKLER5FE0UIpED ❑vEs uNo STATEBUILDIN^,SURCHARGE <br /> STATE ENEFiGY SURCHAHGE <br /> �PPLICFTION ALG BY PLANS AVPR BY <br /> PUBLIC WORKS <br /> TOTAL <br />