Laserfiche WebLink
p�;'.::t ",�:j <br /> ARPLIGATI'�aiN FOR COPISTRUC�r��ON RERMItT <br /> i ev� <br /> I�e Evorgraon � � ' , <br /> CI7Y OF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> ❑ DEMOLITION ❑ COMBINATION I 1 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> oWNEp � ranl�nn�ss �c�IGr��L Y/�Volr ,�� 2� � PHONE <br /> / 1 . �i t1�c�co- y�svrz <br /> ���►-v � �.�s 1 �e <br /> TENANT MAILA�DflESS CITV ZIP PHONE <br /> AHCHITECTOflDESIGNEFi MAILA�OflESS CITY ZIP PHONE <br /> GENERALCONTRpCTOR MAILAD�RESS CITY 21P PHONE LICENSEI <br /> MECHANI9 AL CONTflACTOR IAAIL ADDRESS � CITY ZIP PHONE �ICENSE o <br /> a We/l5 ,r�c�G,�;« �i C-� 5E �� k�����h �1��� d3,Y5�7.1/ a�3azw��c s� arz, <br /> PLUM9INGCONTRALTOfl IdA1LADOflESS CITY ZIP PHONE LIC[NSE/ <br /> CLASS OF RORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR Cl DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TE9M1T IMPROVEIAENT OR INTERIOA REMODR ONLY CONTACT PERSON AND PHONE NO. <br /> WNTRACT PflICE OF WORK: <br /> DESCflIBE WOflK ANO SOUAflE FOOTAGE INVOLVED <br /> �C L(�/�-'c 2�`' <br /> PflOPO5EDU5E ewioir+ � � �. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> k2 . -��<<�� �-..�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGRLDESCRIPTIONOPPflOPEflTY�SHOWNBELOWORAiTACHFOUflLOPIES) PROVI.`,IONSOFLAWSANDOFDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT BLOCN oF NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TIiE PROVISIONS OF ANY <br /> OTFiER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> . CONTHACTOAS LAW 18.27 RCW AND 296200 WAC. <br /> SIGNATUflEOFCONTRACTORORAl1THOfl12EDAGENT DATE <br /> Pfl0.1ECTA0DRE55 /� �� —� �� <br /> �� /� APPLICANTS CIN BUSINESS LICENSE NO.AND BUSINEuS NAME <br /> V � `.) <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYr'E OF EOUIPMENT FEE <br /> WATER CLOSET(TOILFT) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; � FORCEDP.IRSYSTEMS—B.T.U. M E.A. '—" <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER ' <br /> CLOTHES WASHER � WOOD STOVE __� <br /> UflINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> 6ACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETr. ) ; � <br /> � � <br /> � � <br /> � � <br /> ' � — <br /> , — —���, <br /> SUH TOTAL $ ' SUB TOTAL $ ( "— <br /> � <br /> PERMIT $ � PERMIT $ i — <br /> TOTAL FEE $ ' TOTAL FEE $ ' � <br /> FRONT SETBACK flEAR SETBACK SIOE SETBACN Pl.AN CHEQ(NUMBER FEE FECEIPT NO.• <br /> USE20NE LOTAREA VACANTSITE FEES VALUATION FEE <br /> �l YES ❑ NO pUILDING . � ' <br /> TYPEOFWNSi.ALl047A81E lYPEOFCONST.ACIDAL actuveNtY 1io0ioWEwNGUNIrs � '— <br /> cxouv pLUMBiNG i <br /> SIZEOFBLW. NO.OFSTORIES DASEMENT �,�ECHANICAL �L i� <br /> ❑ ves ri No � <br /> OCCUPANCY LOAU FIRE SPRNKLEFS REO'0 NEIGNT UlAITATIOtI OTHER � <br /> ❑ YES ❑ NO STATE B111L01NG SURCHARGE ; <br /> REASON FOR SPRINKLERS <br /> STATEENERGYSURCHARGE � <br /> i <br /> APPLICATIONACC.BY FLANSAPPROVEDBY CITY OF EVERETT PUBLIC WORKS i <br /> LUCAL SALES '—�_ <br /> TAX CODE IS 3105 TOTAL � <br />