Laserfiche WebLink
r �/�7. <br />J�' APPLICATIt►..� F'OR CONSTRUC9,�bN PERMIT <br />; <br />; (he Evcrgreen <br />� CI7Y OF <br />; everett <br />BUILDING DEPARTMENT <br />259-nd10 TO BE COMPLETED IN <br />; ❑ DEMOLITION i I COMBINATION I I BUILDING <br />O NER � MNIp DRFSS li <br />����-�:h ��_� �-��`� - a � I�i -� r� } <br />' TFl1ANT MrlRp00RE55 a�v <br />OR �ESIGNEfl A'AIL AODRF55 <br />CITV <br />CITV <br />� <br />CIiV <br />�LEASE PRINT <br />y�ECHANICAL ! i PLUMBING <br />Z�—C���PHONE��^ �� t>L�I L <br />_; <br />21P PHONE <br />ZIP PNONE <br />PNOIJE I ENS M <br />--,_'����a � �; <br />PH0�1E UCENSE � <br />everett <br />e <br />f_1 SIGN <br />�uy. — _ <br />Y•.., PLUMBINGCONTRACTOfi MNLn0U11G55 C17Y 7iP P110nE LIGENSEI <br />'' CLASSOFWORK <br />:"��- �� I.I NEW I I ADD�TION yLiERATION I I REPAIR � � DEh10LITION �� WOODSTOVEIFRPL INSERT i I BUILDING RELOCATION <br />TENANT IMPROVEMENi OR INLEnf110B REcMOO/�[_l ONLY CONiAC I PEfISON �NO PHORE Np <br />CON1 PRCT PRICE OF WORH: . Z� JIfJ� �� ____ <br />�(9��� � DESCNIB: WORKnNOSOl1�PEF In(:EINVOLVED I <br />� _ �i1`,—�(,��P,U h�. c� - -�i L�)1- <br />PROPOSEDUS?OFBUIID�NG j� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />���� L� � IU APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL <br />, �� � �. --�-----.... . __ _. . __. __...- -__---- - .. . - -- --� <br />.. ' LOT _ BLOCK GF <br />AO�RE55 /1 �) I /'� M � <br />�f L/ ` � <br />MBIN3 <br />� TYPE OF FIXTURE OR I <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINY. 8 DISP _ <br />DISHWASHER <br />LAUNDRY TRAY _ <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FRONiSETBACK <br />USE ZONE <br />ttPE Of CONSC ALLOWABIE <br />SI2E OF OLDG. <br />UCCUPANCYLOAD <br />REASON FOR SPRiNNLERS <br />APPLIC�!ION ACC. B'I <br />FEE <br />PROVISIONS OF LAWS AND ORDIN�NCES GOVEFNING THIP. TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATF OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OWNER Of TIiIS PROPFRTY TO PERFORM THE WORK FOR WHICH <br />APPLICATIiiN IS MADF AND I COMPLY WITH THE STATE <br />CONTR/1CTOf1S LAW 18.27 RCW AND 296.200 WAC. • <br />SIGN�7UREOFWNtfi�G�ORORAUiHORIZED�GENT O�iE <br />APPIIC�NiSC�VBU51 ESSLICENSEI:O.���ES� ��/I�� <br />MECHANICpL � <br />NO. TYPE OF EQUIPMENT FEE <br />NC—A�HNDLG UNITS—H.P. T <br />� FOFiCED AIR SYSTEPAS—B.T,I E.A. ; <br />UNITHEA?ERS—B.T.U. M � <br />- T <br />CLOTFIES DRYERS � <br />VcNTILATION FAN ; <br />RANGEHQOD � <br />METAL FIREPLACE � <br />FIREFL�CE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHl1UST F�N <br />SUB TOTAL $ <br />PERMI'f $ � <br />TOTAL FEE $ ; <br />REAOSETB�CK SI�ESET�AQ( PL�NCHECKNUMOER <br />LOTAREA VAC�NiSIiE FEES <br />! I YES I I NO OUiLDirvG <br />IYPEOfC01lS1.AGIVAL o[curexcr boelvx[mxeubi�s <br />�aWr PL11A101NG <br />NOAFSTORIES DASEMENT MGCHANICAL <br />I I YES I I NO <br />fIRE5Pfi11KLER5f1EOD HEIGHiLIMItNION OTII[fi <br />I I YES I I NO STATE BUILDING SURCIIARGE <br />STATE EYERGY SURCf{pqGE <br />P�nNsarrnoveoav CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTa� <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FEE RECEIPiNO. <br />O � <br />f � <br />—�— <br />�._ <br />I <br />T � <br />i I� <br />i I <br />i I <br />T <br />��_ � <br />� <br />i <br />i <br />i <br />T <br />i <br />: <br />i <br />T <br />'�p0 <br />� I <br />