Laserfiche WebLink
' � �;';i� h�;.1 <br /> APPLICATION�'�OR CONSTRUCTI�'�1 PERMIT <br /> everett " <br /> Ihe Eve�groen `� � � � <br /> CITY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> ❑ DEMOLITION i7 COMBINATION �BUILDING I 1 MECHANICAL ❑PLUMSING ❑ SIGN <br /> OWNER MAILAODRE55 qTY ZIP PHONE <br /> Croshu l�orne.� ►,ti � l�000 vri��� cv�-'�.��',,,fi, m�11 c,wePw. � ,a, '�4s- 0292 <br /> TENANT � MAiL AOORESS CITY ZIP PHONE <br /> ApCNITEGTOHDESIGNEfl AIAILADDRESS GITY ZIP PHONE <br /> GENEMLCONTRACTOR MAILADDRESS QTY ZIP PHONE LICF.NSEp <br /> �� G2�SRGH I 1 '7 L.�� <br /> � MECHANICAL CONTRACTOfl MAIL ADDRESS QTY ZIP PHONE LICENSE I <br /> PLWABINGLONTRACTOR IAAILAD�RESS CITY ZIP Pf10NE LICENSE/ <br /> CUSS OF WOflK <br /> � NEW ❑ ADDITION ❑ ALTERATION I_l I7EPAIR I.I DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TENANT IMPROVEMENT OR'NTERIOfl REMODEL ONLV (�('� CO/N�7ACT PEflS1O�N Al/lD-.PHONE NO. `' <br /> CONTRACTPRICEOFWOFlN: �U� 1 ��L•Y l `/�bJ � �1 S—O� 31 <br /> DESGfl16E WORN AN�S�URPE FOOTAGE INVOLVED <br /> U <br /> PHOPOSEDl15EOFBIliL01NG � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALOESCflIPTIONOFPflOPEflTY�S110WN�ELOWORATf�CHFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �.or�_ B��K 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 flEGULATING CONSTRUCTION OR THE <br /> PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TFIIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> — • CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGNFTURE OF CONTRRCTOfl Ofl AUTHOflIZEO AGENT OA1E <br /> X , _ ,�j __„_y_ <br /> PflOJEGT ADDRE55 'TipP�ICRNTS CITY�USINESS UCENSE NO.AND BUSINE55 NAME <br /> a� - st �. E.,.� 3.� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATEFS—B.T.U. M � <br /> SHOWER ' CLOTHES�RYERS � _ <br /> KITCHEN SINK&DISP � VENTILATION FAN � , <br /> � HANGE HOOD ' ` � <br /> DISHWASHER Wp7ER HEATER � � � <br /> LAUNDRYTRAY � � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL ' _ METAL FIREPLACE 8 CHIMNEY ' <br /> ' FIREPLACE INSERT � <br /> DRINKING FOUNTAIN ' <br /> FLOOR DRAIN � HEAT PUMP �_ <br /> BACKFLOW PREVENTERS ; GAS PIPING �_ <br /> FOOF DRAINS—RAINLEADERS � EXHAUST FAN '_ <br /> SINK(SERVICE—BAR,ETC.) � � <br /> —i— ' <br /> � �-- <br /> � <br /> — � <br /> � ' <br /> � ' <br /> —� , <br /> � <br /> � SUB TOTAL $ ' <br /> SUB TOTAL $ ___T_ <br /> PERMIT $ � PEFMIT $ �_ <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FPONTSETBAC REARSET CN SIDESEYCIf ���Cfl ;�U`[�E(i�� P � ��� pECEIPTNO. <br /> KC <br /> usezc�, � �ot EA VACANTSITE FEES VALUATION FEE <br /> �` I.1 YES NO BUILDWG � � �I ��I 1 <br /> ttPEOFCONST.ALLOWABIF ttPEOFt@IST.ACTUAL acuru¢v no�Fowtui4cuxns i <br /> cn�ur pLUMBING �_ <br /> -� A <br /> � <br /> SIZEGFBLDG. � ��O.OFSTORIES BASEMENT MECFIANICAL � <br /> � S t I I YES I�( NO ; <br /> OCCIIPANCYLOPO flRESPRNNLERSREO'D NEIGHTIIMITATIOH OTHER � <br /> N Q ❑ YES GC NO AI P STATE BUILDING SURCHAFiGE 'LI i_ �� <br /> flEASON FOfl SPFlINKLERS � <br /> STATE ENERGY SU(iCHARGE � <br /> APPLICATIONACC.BY PIANSAPPROVEDBY CITYOFEVERETT PUBLICWORKS _� <br /> /�} LOCAL SALES n���� <br /> '� '- TAX CODE IS 3105 TOTAL � J <br /> . � <br />