Laserfiche WebLink
FROM:EVERETT BUILDING DF=. TO: 2066433475 ,.TAN 171 1992 2: 13PM 4412 P.02 <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> �/ 3> vL,1C: - q4-- TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> C % � U <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS U ELECTRIC IJ_ i� <br /> 259.0010 <br /> 1 1 DEMOLITION I I COMBINATION — BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br /> OWN N MAR Ar RCRS CITY ilo PHO <br /> /:0 /yy(U/���it cc! /P�'a0� / ire✓c.�. 9�'OG NE 7 <br /> TENANT MAR ADDILES CITY zlr PIIONE �— <br /> ARCNITFCI ON UEBIONCn MAIL AUUMESS CIl) zip rI1ONF <br /> --' -GCL✓cmc 1 fyc5 7�( 30�� _ <br /> Dl NERAL CONTRACTOR MAR ADONC65 I CITY 21P PHONE STATF IlOVISEI <br /> a cS I�tTJ�ur Caul�`riaro�ns� <br /> uFCHANIOAl Cd/TnACinR MAR AUOnESS CITY ZIP I'MONE S1AT[uDCNSFI <br /> PLUMBIHUCWFLACTOR MA A1DIIENS CITY 21P YNOHC 6IAELIC[NVI <br /> CUSS 0.WOnK <br /> KNEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOV&FRPL INSERT I I BUILDING RELOCATION <br /> .. .. . cDNTAc�TPcn6oNA�mIDx No. <br /> DCSC.RACI WORK <br /> OF won <br /> S0VA _�f6J3.L`fi� <br /> O[6CRIRF WDRK ANU 9UVARCfDOTA [INVry VFP <br /> id <br /> PH T"EDUSCOraTI-IRnINO I HEREGY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> z <br /> ^ T G<yLr ILI IlCe CGe-(i Gr_ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IL(%ALy cnlrnoNnrPAOPFRTYI6OWNBELOWUnnTLWIiFDVRCOPIEB) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LOT� BLOCK OF 'jam /'lam// WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMC TO GIVE <br /> �� . � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> .,. L�/,,&dj /O7 OTHER 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 /> F - APPLICATION IS MAGE AND I COMPLY WITH 1HE STATE <br /> CONTRACTORS LAW 10.27 ROW AND 2DS.200 WAC. 1 <br /> YNOJLL`t ADDOCSi F+:NAllnl (UTI <br /> CIIT YIAINIAA I IrINI�NO <br /> PLUMBING ' MECHANICAL _ <br /> NO. TYPE OF r IXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 7 WATER CLOSET (TOILET) I A1C•-AIHNDLG UNITS-H.P. I <br /> BATHI UB FORCED AIR SYSTEMS-D.J.U. M E.A. _ <br /> LAVATORY(WASH BASIN) I UNIT HEATERS-D.T.U. M - <br /> __ SHOWER ' _ CLOTHES DRYERS <br /> / KITCHEN SINK&DISP _ I VENTILATION FAN <br /> DISHWASHER ' I RANGr HOOD —� <br /> / LAUNDRY TRAY I WATER HEATER ' <br /> CLOTHES WASHER _ T— WDODSTOVE I_ <br /> _ URINAL ' _I METAL,FIREPLACE 9 CHIMNEY —� <br /> DRINKING FOUNTAIN i FIREPLACE_INSERT <br /> FLOOR DRAIN j HEAT PUMP <br /> BACKFLOW PREVENTFRS I OAS PIPING ' <br /> _ ROOF DRAINS-RAINLEADERS I _ EXHAUST FAN <br /> SINK(SERVICE-DAR,ETC.) I I <br /> I <br /> _ SUB TOTAL S I _ SUB TOTAL S ; <br /> PERMIT $ _ ' _ PERM!T S <br /> TOTAL FEE $ TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: Lltwt ; 1 <br /> •nCA1T6rTAACK nCAR R[TAACX I SIDC SSTDACK, rLAH ALCLIPI NO. <br /> -7 <br /> _s�� — <br /> .at zUNe LOl AnL Y A VACANT SITE FEES VALUATION �FEE <br /> e -`J Iq,6611 BUILDING f3102e, <br /> rr{m CONT2.Al1OWAILl lTrC of CnxS•.1C1UlL pcw.cT YR pIwnLNL WIII / 1 <br /> _N I IAa3 1 PLUMBING ((�_ <br /> i 12E OF Dl I10 ND.nr R70RIEE6 DASCM Ni MF <br /> 3.3Fi Sf t „ fL� - DM N AL <br /> GS .rrf Gn.,j. �V <br /> rCUPANCYLOAU Nn[sppm FRS hEQO NCIOIITLWITATION ADRIONI.PLAN CIICCK �{ I <br /> L m <br /> IEASDN Yon SPRINKI FRB 7) <br /> STATE BUILDING SURCHARGE i 9 <br /> ,inK[Rr - riiNS APPAoVFO BY CITY OF EVEHETT PURLIO WORKS <br /> �J LOCAL SALES <br /> TAX CODE IS 3105 TOTAL 3 <br />