Laserfiche WebLink
�PPLICATIO"^ FOR CONSTRUCT[l`N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BU��DING DEPARTMENT HEATING SYSTEM: �GAS J ELECTRIC 'J <br /> 259-8810 <br /> ! DEMOLITION I COMBINATION I i BUILDING �YMECHANICAL I_1 PLUh1BING 1 SIGN <br /> OWNEP IdqIL��DRE55 CITV ZIP PHONE <br /> , uG,�s �a�os �o� D� s� f��«fl 98aD1 7yS- 5�338 <br /> TENA � IdAII.AGORE55 CRY ZIP PNONE <br /> ARCNITECTOR�ESIGHfN fAAILA�ORE55 CITY ZIP PMONE <br /> GEtlERALCONTRFGiOR MFILADDRESS GITY ZIP PHONE STATELICENSEa <br /> MCCNANIGALCO�lTA�C1JR 1AAiLAD�PE55 CITV ZIP PHONE STATELICENSEn <br /> C°�J��;�4 �oa�l � 7� /�uE �����„ 9x??� ;'�s-�l9oy - � 1� y <br /> PWMBINGC NTRFCTOP A1M FDDFESS CITY ZIP PHONE STATEL'CENSEx <br /> CONTR�CT PRI� � �� �� — ',. <br /> Tr <br /> DESCRIBEWORKANDSOUAREFOOIDGEINVOIVED � C ' CONTAGTPERSONpNDPHONENO <br /> J <br /> n.STa/ .S � l�/� d/� CGl� II <br /> Fi;J/1RGC�_ d V� N-0' Gi' I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS I <br /> Paoaoseo use oF ew�oiNc APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND OADINANCES GOVERNING THIS TYPE OF I, <br /> LEGALOESCRIPTIONOFPFOPERTV�SMOWNEELOWORATT�CHNlOCOPIES) WORK WILL BE COMPLE7ED WITH WHETHER SPEGFIED HEREIN OR � <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE . <br /> . �oT BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY �. <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> — PERFORM1IANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWfJER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE 'i <br /> PARCEL T�%ID NUM�[R CUNTRACTORS LAW 18.27 RCW AND 296200 WAC. I <br /> CONSTRIICT�ONI.OANLEN�ER.A00RE5S.TELEPHONE NUMBER � i <br /> � � S-/ '9� <br /> PROJECT ADDRESS sic �� oaie —� <br /> ci rou.,irvess�¢E�servo <br /> PLUMBING MECHANICAL <br /> NU. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �vVATER CLOSET(TUILET) A�C—A/HNDLG UNITS—H.P. � <br /> � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORY(WASH BASIN) � UNIT HEATEfiS—B.T.U. M I <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK&D13P ; VENTILATION FAN I <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) _ <br /> DRINKING FOUNTAIN FIREPLACE INSERT _� <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—P,.1iNLEADERS � EXhIAUST FAN � <br /> � � SINK(SEFVICE—BAR,ETC.) I <br /> � <br /> � <br /> � <br /> SUB TOTAL 3 ; SUB TOTAL $ C� ' � <br /> PERMIT 5 � PERMIT S /S � <br /> TOTAI FEE $ ' TOTAL FEE 5 7.� ' � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB4CK REARSETBACK SI�ESETNACK PLANCHECKNU 1BEF � FEE REGEIPTRO. <br /> 7 T"! <br /> ,)a<� <br /> usEzoNe �ornnen VACANTSITE FEES VALUATION FEE <br /> I YES ,�1 NO BUILDING ' <br /> iYPEGfWNSi NO.OFSTORiES ormaaucr sooro��vttu•iGwu�, � <br /> ceou.� PLUh1BING � <br /> i <br /> SIZEOFBLOC. FIRESPPINNLERSREO'0 BASEMENT MECHANICAL <br /> .-: YES !7 NO � <br /> OCCUPANCYLOAD FIRE4L4R61REOD HEIGMiLRdITATION ADDITIONALPLANCHECK <br /> OTHER <br /> T <br /> REASON <br /> STATE BUIL�ING SURCHARGE � <br /> INTAKEBY �'LANSFPPROVEDBV CITY OF EVERETT PUBLIG WORK� � <br /> LOCAL SALES � <br /> onre TAX COOE IS 3105 TOTAL <br />