Laserfiche WebLink
,r.. <br /> ,.�.�; _ t� .•,•� <br /> APPLICATt�:N FOFi CONSTRId�'Y�`ON PEROJlIT <br /> i everett <br /> Ihe Evorproon � • ' � <br /> CIN OF <br /> everett <br /> BUILDING D�PARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> ❑ DEMOLITIQN ❑ COMBINATION I:I BUILDING IJ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> WNE� MAILACDREfiS GITY ' ZIP PH1 NE <br /> ,�ros� 5 ic� a����e�. r1���,! �aa� ��r�-:� 9��, <br /> TENANT MAILADDRESS LITY ZIP PNONE <br /> APCHITECT Ofl DESIGNER MAIL ADOflESS CITY ZIP PHONE <br /> GENEflALCONTflRCTOR MAILAODRESS CITY ZIP PH011E �ICENSEN <br /> ' MECHANfCAL CONTRACTOR lAAIL ADDRESS /CITY 21P PHONE UCENSE N <br /> 11L�-e��S �cS�iG-�i 3�1 G' S•�- SC..� Avlv�i�v� `1���'� �3�Y�2/ .1�3 o2c...ic[� Si 2�z JF <br /> PlUM81NG CONTRACTOfl MAIL AD�RESS CITY ZIP PIIONE LICENSE p <br /> ClA55OF WORN <br /> ❑ NEW CI ADDITION ❑ ALTERATION I.i HEPAIR C; UEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TENANT IMf�OVEM:NT OR INTERIOR REMOOEL ONLY CONTACT PER501!AND PHONE NO. <br /> CIXJTRAGT?flICE OF WORK: — <br /> DESC IDE NORK AND SOUARE FOGTAGE INVOLVEO <br /> ��� V�- C 2�f:�� <br /> pnoroSeouSe Fewiou+c / ' I HEREBY CERTIFY THAT I HAVE REA� AND EXAMINED THIS <br /> �'�,�J���^.���� �YVc-.t�_ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALOESCAIP110NJFPflOPEflTY�Sl10WNBELOWORATfAC11FOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COPAPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �pT e�ocH oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO FERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � . CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> — SIGNAiU CONTRACTOR RA MORREOAGENT DATE <br /> �-- �'� '�� <br /> PNQIECTA DRESS t(, 1 <br /> /� � C I APPUCFN S CITV BUSINESS LICENSE NO.AND Bt151NES5 NAME <br /> pLUMBWG MFCHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE Of EOUIPMENT FEE <br /> WA7ER CLOSET(TOILET) � A/C—AIHNDLG UNITS—H.P. �-�! <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. / • � <br /> LAVATORY;WASH BASIN) � UNIT HEATERS—B.T.U. M _T <br /> SHOWER ' CLOTHESDRYERS ' <br /> KITCHEN SINK&DISP � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> LAUNORY TRAY _�, WATER HEATEfl ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> —'— EXHAUSTFAN <br /> ROOF DRAINS—RAIMIEADERS ' � <br /> SINK(SERVICE—BAF,ETC.) � ' <br /> --r— ' <br /> � ' <br /> — , � <br /> , — � <br /> ' _—� <br /> — � � <br /> SUB TUTAL $ ' SUB TOTAL $ ''— <br /> � ' <br /> PERMIT $ —�—� PERMIT $ 7�� <br /> TOTAL FEE $ <br /> � TOTAL FEE $ ' �— <br /> FflONT SETEACK REAF SETOFCK SIDE SETOACK PLAN CHECK NUAI�Efl FEE �ECEIPT NO. I <br /> usezoNe �otneea VACANTSITE FEES VALUATION FEE I'I <br /> [�I YES I I NO BUILDING i �� <br /> 7YPEOfC0115TALLOWABLE iYPEOfCONSi.AG111AL a[uvexCv NoofmvtWbtUunS - i <br /> txoua pLUM�ING i <br /> SREOFBLDG. NO.OFSTORI[5 DASEMEtlT � <br /> MECHANICAL � <br /> fl YES I_�I NC --�-�� <br /> i <br /> OCCUPANCYLOAD FIRESPRNNLERSFiEO'D HEIGHTLIlAITATtON OTHER � <br /> i <br /> ❑ YES l� NO STATE BUILDING SURCH,IRGE ' <br /> i <br /> flEASON FOR SPflINNLEPS i <br /> STATEENERGYSURCHARGE � <br /> APP.ICATIUNAGQBY PLANSRPPPOVEDBY CITYOFEVEflER PU�LICWORKS i <br /> LOCAL SALES � _ <br /> TAX CODE IS 3105 70TAL ' <br />