Laserfiche WebLink
� . �`�'I�`�S <br /> � APPLIC�ION FOR COi�ISTRI.�TION <br /> PERMIT <br /> the Eirerpreen evr.relt <br />�*,"'- , CITY OF � <br />, - everett <br /> ; BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � OWNEP MAILAO�RESS GIiV ZIP PMONE <br />�;- <br /> ��e,- �llnec��o� Il�ll �l P�oltx�� L. �rEl Il���s.u�a.c����-1�'rX�3 � ���� ,�o�l� <br /> . TENAIIT MAILAOORE55 C,Y lIP PHONE <br />�ic{ _—_ <br /> � �RCHITECTOROESIGNER MAILFD01iE55 GIfY 21P PHONE <br />� <br /> �ENEPALCONTPpCTOR MRILAD�RESS GItY 21P PMONE 4CENSE• <br /> � ECHANICALLONTNRCIOR C M/AILPO/DaE5t5 ' ( CiIY I (/_/��Z)IP PHO/NE ^ LICENSE• <br /> . �QI.NI(jl.1/RACTop�l�� �_ L] Jl.l•VD, 151� ILlJ�,L�I(JC�� ��I�G �_�{ --I•JC/LI ��/ ���JII(� ���LI.LICC7I-')LJ� <br /> CLA33OF WORN <br /> ❑ NEW ❑ ADDITION 'ALTERATION ❑ REPAIF ❑ �EMOLIiION ❑ WOODSTOVE/FRPL INSERf ❑ BUILDING RELOCA?ION <br /> ' 7EN�NTIMPPOVEMENTORINLER10 REMO�EIONIV CONinCIPER50NANpP110NEN0. <br /> CONTRALT PRICE JF WORK - <br /> � D GRIBEWOPKAry�q)SOUAREFOOiAGEINVOLVED <br /> . �"3�,-`� 1- � 1-' � �`� - — — <br /> l <br /> - rao 9Eo�5e;��iN�� ( �HEREBYCEfiTIFYTHATIIIAVEREADANDEXAMINEDTHISAPPUCATIONAND <br /> ` � <br /> / � KNOWTHESAME"OBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> �- ORDINANC[5 GOVERNING Tf{IS TYPE OF WORK WILI BE COMPLETED WITH <br /> LEOALUESGNIPTIONOFPROFERTY�SHOWNBELOWORI'TpLHfOl1flCOP�E51 WHE7HERSPECIFIEDHEREINORNOT.THEGRANTINGOPAPERMITDOESNOT <br /> � PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> Lo� B�oCK oF . ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> � THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> j AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 W.4C. <br /> $IGNAIUREOFGONiRACiORORAUi110FIZF.OAGEkT ORiE <br /> � � � .�-FV� `� Xvl�q��nQ ' � IICIC�/ ���a-�I� <br /> PROJECTRD�RE55 � qPP�IChNi� ItvBU51NE55U ENSENO.�NDBUSiNE55NAME � <br /> ; � � L� I�I � <br /> d PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OH ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILE'� A/C—A/HNDLCa UNITS—H.P. , <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M EA <br /> a LAVATORY�WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> 'j SHOWEF _ CLOTHES DRYERS _ <br /> ; KITCHEN SINK 8 DISP. _ VENTILA710N FAN <br /> DISHWASHER RANGEHOOD _ _ <br /> LAUNDRY TRAY WATER HEATER <br /> ; CLOTHESWASHER WOODSTOV[ <br /> � URINAL METALFIREPLACEBCHIMNEY <br /> DP.INKING FOUNTAIN FIREPLACE INSERT <br /> FLOOF DRAW _ HEAT PUMP <br /> � BACKFLOW PREVENTERS t GAS PIPING ___ � <br /> �� ROOF DRAINS—RAINLEADERS ExHAUST fAN <br /> SINKISERVICE—BAR,ETC.) _ . <br /> ' —_— <br /> � —— _ I <br /> � SUB TUTAL 5 5:18 TOTP L 5 I <br /> ' ' PERMIT S PEF+AIT 5 — <br /> � I <br /> ,j TOTAL FEE $ TO7AL FEE S <br /> � FRONTSETBAGH FEARSETBr1GK SIOESEiBAGN PUNCNECNNUMBEN FEE HECEIPfNO. I <br /> i <br /> usE2oNe LOiARER VRC�NiSRE FEES VALUATION FEE �. <br /> ❑YES ❑NO <br /> � BUILDING <br /> 1 <br /> � lVPEOFCANST. OCCUPANCYGROUP NOOFpWELLINpUNItS - -- <br /> , e��oW�6LEUCTw� PLUM1I�MG �� <br /> SREOFBLDl3. NO.OFStORIES BSMi. OCClO/D M'cCHANICAL _��_ � <br /> OY <br /> ❑N -- <br /> , HEIGHI LIMIIFiION OTHER �. <br /> - fIREBPRINNLE85RE0UIRED ❑vE5 nNo STATEBUIL�WGSURCHARGE <br /> � SThTE ENERGV SURCFU�RGE <br /> APVLIC�TIONALGBY PUNS�PPR.BV PUBLICWORKS <br /> TOTAL �� <br /> i <br /> � I <br /> � <br /> , _...... . ............._.... . _ . . ......-.-.;...: ,:� . ,--->. .._:...-._,._: <br />