Laserfiche WebLink
AI�PLICATI�.rd FOR CONSTRUCZ�DN PERMIT �"`'�`'" <br />' tneE�er9reen TO BE COMPLETED IN INK—PLEASE PRINT � <br />arv oF <br />everett <br />BUILDING DEPARTMENT <br />59-8810 <br />HEATING SYSTEM: (d GAS ❑ ELECTRIC ❑ <br />2 � � <br />DEMOLITION COMBINATION �/ BUILDING MECHANICAL PLUMBING SIGN <br />O�YNEfl IAAILADDRESS CRv ZIP PNONE <br />r�e kN, ��r, �-�� 3oia i�'�JT �'v�2�iT- �l-� - i��f� <br />TENANT MNI.A�DRESS GTY 21P PHONE <br />AflCHITECTOR�ESIGNER MAILF��RE55 CIiY Z�P PHONE <br />GENERalC01lTFAGTOB MAILADDRES$ CITY ZIP PMONE LIC[NSEa <br />�f.��/c%f� f li�«/ �/�f�/ NF,��7<. i/ /!ii S�f'//� �/�� �r'd �i'/-!,� 9l 5' l'F��d� /9YC'I <br />MECHANICALGONiRACTOR MAI�ADOPE55 CRY ZIP PHONE U ENSE <br />PLt1MBING G011TRACTOR MML F�DPESS <br />CITY 21P PHONE LIGENSE � <br />CLA55 OF WORN ' <br />�. NEW (��DDITION .- ALTERATION � REPAIR DEMOUTION . WOODSTOVEIFFPL INSERT _. BUILGNG RELOCATION <br />/� CONTACT P'�RSON AND PHONE N0. � /_O � C <br />� �,h �rl � ' ' � ,.-.��` Y <br />CONTRACT PRICE OF WORK _ <br />OESCRIBE WORK AND SOUARE F00 F E INVOLVED <br />'� �� - � ;, � , : fT. <br />aaoaoseouseoFew�oir+c V�t � I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br />T APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />� ` PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEG4LOESCBIPTIONOFPROPERTVISnHOWNBELOYJORATTACHFOURCOPIE51 y,/ORK WILL BE COMPLE7ED WITH WHETHER SP=CIFIED HEREIN OR <br />�or l BLOGK �6 % oF � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUtdE TO GIVE <br />TY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />E <br />� `� <br />3�7-ao�-- <br />aNaecr noonEss <br />_� //I l! <br />PLUMBING <br />N0. TYPE OF FIXTI <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY(WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENI <br />ROOF DRAIPIS—RAIN <br />SINK (SERVICE—BAR <br />� �J S% <br />IE OR ITEM <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE S <br />AUTHORI <br />OTHER STATE OR I.00AI_ LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED EiY THE <br />s OWNER OF THIS PROPERTY TO PERFORM THE YJORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTFACTORS LAW 78.27 RCW AND 296200 WAC. <br />SiGNATUFEOFCONTRFCTOROR�UTHORREDAGENT DNE <br />X . <br />— � fr�--Y-�--- <br />nv i ireurn.e i5WE5S IICENSE N0. AND 9USINE55 NAME <br />FEE <br />0 <br />NO. TYPE OF EOUIPMENi <br />NC—FVIiNDLG UNITS—H.P. <br />FORCED AIR S`!STEMS—B.T.U. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PU�dF <br />GAS PIPING <br />EXHAUSTFAN <br />FOR OFFICE USE ONLY: <br />FRONT SE�C, REAR SETBACK SIOE SETB�GK PLAN HECK NUh1BER <br />� �tj v�i'/�� <br />u5[20NE LOTAR[A VAGA.NTISITE FEES <br />��Z SZ MO BUILDING <br />i'!Pf 0� WIl15. AItOWAB�E IYPE Of CONSi AC7l1AL o[��'� �6r xo O�OwFwri6 uwi5 <br />� PLUMBING <br />�' 'e' <br />SIZE OF �L�G. ND. Of STORIES BASEMENT MECHANICAL <br />�va sP aoau 2 N <br />/ e f� OEC qDDIT10NAl PLAN CHECK <br />OCCUPANCVLOAO FlRESPRNNLERSREO'G MEiGHTLIIAITA,ION <br />,{� OTHER <br />REASONFORSPRINNlERS �`� <br />STATE 9UILDIIJG SUfiCNARGE <br />INTnKE�V PLANS�PPROVEOBV CITYOFEVERE7T PUBLICWOFV:f <br />��,I LOCALSALES <br />d �ti�u, TAX CODE IS 3105 TOTAL <br />FEE <br />� <br />E.A. <br />� <br />� <br />SUB TOTAL S ' <br />PERMIT 5 � <br />TOTAL FEE S <br />RECEIPT NO <br />� <br />� <br />� <br />� <br />�� <br />� SG <br />