Laserfiche WebLink
��s <br /> pppLlG.aTION FOR CONSTRJCTION � <br /> PERMIT <br /> �he Everpreen everett <br /> CITY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAII�.DDRE:iS LrtY ZIP PNOHE <br /> JoHN r��NDA R��EN �O`, �*H HVES�' EI/Ere� i� 98z�3 3s�7-5`968 _ <br /> TEN�NT MAILADDR255 GiY 2iP PNONE <br /> AFCHITEGTOROESIGNER MRILA�DRE55 GIiY ZiP PNONE <br /> GENEMLCONTR�GTOR MRILADORE55 CITY 2iP GMONE UCENSE• <br /> EI/eRFif 4u(��iaKS iNc SGn6aV�'�2Ga:�rN vVny Ef/��ET 9Er2v3 3'�37iG1 £✓-ER-�3�r3��� Pk <br /> MEGMANICALCONTRFGTOH MRILAD�BESS CITY ZIP PMONE LiCENSE+ <br /> PLUMBINGGONTRALTOP MMLA�DRE55 CRY 21P PnJNE UCENSE• <br /> CU53OF WOPN�q <br /> ❑ NEW p A�OITION ❑ ALTERATION ❑ REPiJR ❑ DEIAOLITION ❑ WOODSTOVE/FRPL INSERT ❑ Bl11LDING�{ELOCATIOf. <br /> TEN�NTIMPROVEMENTOFINTE OflHEM00ELONlY CANTRCI�EPSONFN�PHONENO. <br /> .,�}e��,.. J. S%sY oN.E'S 3s3-7ib I <br /> CANTPAGT PRILE OF WOFK <br /> DESCFIBEWOPKANpSpWR FOOTAGEINVOlVEO <br /> � src,eyAo�ir�ou 12x1 -` _�f F�on� i3 '�'e4. <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFV THAT I HA4E READ AND E%AMINED l HIS APPLICATION AND <br /> R�5/���E_ KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> IECvLLDESGRIPTION OF PROPEFtt�SHOWN BELOW ONATtAGN FOUR:OPiE51 ORDINANCES GOVERNING THIS 7YPE OF WORK WILL BE COMPLETED W�TH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A PERMIT DOES NOT <br /> WG�L//J! iGti� MAA�02 PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPROVISIONSOF <br /> Lor� B��K� ��o� ANYOTHERSTATEORLOCALLAINREGULATINGCONSTRUCTIONORTF4EPER- <br /> FORMANGE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> AND Pp00MPLYTWITNRTOHEMSTATE CONTRACTIORSH AWLiB2T�ORCV�MAND <br /> 296200 WAC. <br /> SIGNATUREOFGONTRAC 060PPULNOR12EDAGENT OATE <br /> X � y���yo <br /> ACCT �/�GOO -OGYI-OU? -� �+-- <br /> PROJEGTAODRESS BPPLI SCii BUSME$$UCENSENO.ANOBUS�NESSN�ME <br /> (o r1t ✓� SE €dE�GTi �' <br /> PLUMBINQ MECHANICAL i� <br /> ryp, TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> . ' WpTERCLOSETITOILET) A/C-A/HNDLGUNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M EA <br /> LAVATORY(WASH BASIN) UNIT HEATERS-&T.U. M <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWASHER RANGEHOOD . _. <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLAC CHIMNEY <br /> ORINKING FOUNT FIREPLACE I ERT <br /> FLOOR�RAI HtAT PU - <br /> 9ACKFiO REVENTERS GASP ING <br /> pOOF RAINS-RAINLEAOERS E AUSTFAN <br /> S ISERVICE-BAR,ETC.) <br /> SUBTOTAL 8 SU3TOTAL S . <br /> PERMIT $ P�RM�T $ <br /> TOTALFEE 5 TOTALFEE $ <br /> FRONTSETBPGN AERRSETBRCR SIDESET6�GK PUNCHECKNUMBER FEE�y` JS' * pEGFIPTNO. <br /> •��j� 2U ' 5 ' `)d ass�f'S' 7l0. 0� �i� 9 � <br /> usEzon[�� LOiAREA_ I VACANTSITE FEES VALUATION FEE <br /> ❑YES �2 NO <br /> BUILDINC� ��I � C� _ <br /> TYPEOFLONST. OGCUV�NCYGROUP NO.OFOWE�LINGUNITS <br /> ALIOWABIE/ CTU�L .,� PWMBING <br /> SREOFBIOG. NOAFSTON�ES BSMT. OGGLOAD MECHANICAL <br /> 5u2 S� A��N Z a r <br /> �N J y <br /> NEIGHTLMIiq�lO� OTMERT GM• <br /> 2 c <br /> FIFE SPRINKlER5RE0U1RED ❑YES NO STATE BUILDING SURCHARGE Z1 <br /> STATE ENEFGY SURCHARGE <br /> APVUCRTIONACCBY PUNSAPPR.dV PUBLICWORKS <br /> TOTAL 9 C ' <br /> ��r <br />