Laserfiche WebLink
APPLIC�ION FOR CONSTRI�..:T10N <br /> PERMIT <br />� fhe Evarpreen evere[t �. <br /> CITY OF <br />. everett �/ l7 � <br /> � BUILDINGDEPARTME�iT <br /> 's 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> , <br /> OWNER MAILR�ORE55 LIiY ZIP FHONE <br /> TENANT MAILqDORESS GITY 21P PMONE <br /> �I���/FL. �-6��5 �1J-C. IqTµft-��E ✓—N �c2�-s7 <br /> ARChITECTOPpES�GNER MAILAO�PE55 CiIY ZIP PHONE <br /> GENER�LCONTRACTOR MAILAOOPESS CITY ZIP PNONE UCENS[ <br /> f <br /> � MECHANIGALCONTRAGTOR /� 1AAILAOORE55 GITY 21P PMONE LICENSEx <br /> $ 1�•�GK6,e,�a f.e�� 2 z'Z S , ���oN �sl�s. RX f� _'� 63-1� �f�f EvL-��Zoi.�7 <br /> i PWMBINGGONTRBCTOF MP:LRDDRESS CITY ZIP PHONE �ICENSE• <br /> 7. <br /> �} <br /> gy LLASSOFWJRKrn <br /> i ❑ NEW p- ADDITION ❑ ACf:.7ATION ❑ REPAIH ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ OUIL�IN3 RELOGATION <br /> $ TENFNT IMPROVEMEhTOR INTENIOR P[MOOEL ONLY CONTPCT PEIi50N RND PHONE N0. <br /> < D <br /> � CANTRACT PRIGE OF WORK ` LC,'F PC� /�p�-�\/`-� � �3� � <br /> OE'wFIBEWORKr1ND'-0UAREFOOTAGEINVOLVED pf_v�a£�-S /�K„ `t- <br /> 1� <br /> � O .S.�. �.C. �l�s ��cTwo21F- V <br /> � PAOP09EOUSEOFBUIL�IN� IHEREBYCERTIFY?HATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> ! T�£41 �_ .�S KNOWTHFSAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAtdD <br /> \ ��'��` ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br /> I LEG/�LDES�NUFPROPERttISMOWNBELOWORATTACHFOURCOPIE51 WHETHERSPECIFIEDHEREINORNO7.THEGRANTINGOFAPERMITDOESNOT <br /> ! PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PPOVISIONS OF <br /> � �or_— e�ocK OF ANYOTHERSTATEORLOCALLAWREGULA7 NGCONSTRUCTIONORTHEPEF• <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PfiOPER'fYTO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WiTH ThIE STATE CONTRACTORS LAW 7827 FCW AND <br /> 1 296.200 WAC. <br /> � SIGNPTUREO NTRRCTORORAUTHOFI AGENi �PTE <br /> , � <br /> � X � � <br /> � �,� 2 -z3�9 <br /> � PRQIEGTAO�HE55 � pP ICR TS ITYPU31Nf:55L1 NSENO�ANDBUSINESSNAME <br /> 1 R�o i ; � SE S�„-� <br /> PLUMBIN6 M CHANICAL <br /> NO. TYPE OF FIXTUNE OR ITEM FEE NO. 1YPE OF EOUIPMENT FEE <br /> � WATERCLOSET(TOILEn A/C—A/HNDLGUNITS—H.P. <br /> � BATHTUB FORCED AIR SVSTEMS—B.T.U. M EA <br /> � LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> I <br /> i SHOWER CLOTHESDRYER° <br /> KITCHeN SINKB DISP. VENTILATION FAN <br /> , DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER _ <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL AIETAL FIREPLACE 8 CHIMNEY <br /> � DRINKING FOUNTAIN FIREPLACEINSERT <br /> � FLOORDRAIN h1EATPUMP <br /> � OACKFLOW PREVENTERS GAS PIPING <br /> C <br /> - ROOFDRAINS—RAiNLEAOERc ExHAUSTPAN <br /> G ,� SINK(SERVICE—BAR,ETC� <br /> SUBTOTAL $ SUBTOTAL 5 <br /> PERMIT S PERMIT S i <br /> TOTAL FFE $ TOTAL FEE S <br /> FqON75ETHRCN REARSETOBCK SIDESETB/GK PIANCHELKNUMBEN FEE RECEIPfNO. <br /> USEZONE �OTAREA VRCPNTSITF FEES VALUATION FEE <br /> ❑VES ❑ NO <br /> BUILDING <br /> . flPEOFCONST. OCCUPANCYGROUP NO.OFDWELI.INGUNIfS <br /> AILOWPBLFAGTUAL PLUMBING <br /> SIZE OF BLOG. NOAf STOI.ZS BSMT. OCG LOAO 7 l <br /> p y MECHANICAL L� <br /> ❑ N <br /> � MEiGHTLIMI:PTION OTHEF7 _ <br /> FIqESPRINKLEFS REOUIPED ❑YES ❑NO STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE ' <br /> APPL'CAt10NACGBV PLANSAPPR.BY PUBLICWORKS <br /> �' \ �-�/� <br /> C...-� TOTAL � �J <br />