Laserfiche WebLink
A►PPi.lG.eTIQPJ FOR CO�I�Tf�a�C'TIl91�! <br /> PEF�lIAIT <br /> 1he Erorgreen <br /> CITV OF rvi�mli <br /> � � � everett � <br /> H <br /> BUILDR 9��� .�RTMENT �7�3 ',� `) /,1 L�,� �� 3 '3���'��S UC� <br /> C H 259-P' TO 8E COMPLETED IN INK— PLEASE PRINT <br /> 9 H (n <br /> Y <br /> O\YNB� M0.ILAOORE55 C�tY LIv Pr10YL <br /> / <br /> K o �� 1 c„� � �`t�c�r,�c.� - �`1� - 10�� ��1�, .�t �1_ t�� —L� � ��f�. — <br /> 1-3 .� TLNANL 4�nLLnDCBE55 GrtY 2iP PIIONE <br /> � x Q <br /> �i1 H �sJ p _ <br /> y y H A4CNITECTOROESIGNER NATURAL GA�QOf1e�i�i���� YQ.� ��i�. CITY ZIP PMONE <br /> �y o �y tF25 F Madne Vi��v: Dr. �1)i1�lA(LG II�PL _ <br /> y � GENERALLON1RACi0B C��.r,NlPO. �P_ES��n n�OOl CITY ZIP PIIONE /`/��6ENSf� <br /> a n vrasrao �o� <br /> 9�,A.244� <br /> � [SJ g MELHANICALGONiRAGTOR MAlIAppPE55 CITY ZIP PHONE LICENSL <br /> �V n <br /> H <br /> Zy PLUMBINGWHiRALiOR MAItADDRE55 GIiY 21P PNONE LICENSE� <br /> C z <br /> (�y5 � y C�LF(S$OF WORK <br /> "' H LJ NEW �' ADDITION �J��1 ❑ REPAIR ❑ OEMOLI710PI ❑ WOODSTOVE/FqPLINSERT ❑ BWLOINGflELOCATION <br /> C] G f/� <br /> iENFNT IMPROVEM[Ni OF INiERIOfl REMOO[L ONLY CONiAI�PERSON AND P110NE(N�O <br /> �� [Sf CONTRACTPRICEOFIVORK. � _> "�,� _ 1 L�K����� <br /> 7. H V7 �ESCRIBEWOiVKANO50VAFEFOOTAGEINVOLVE� I , <br /> yom �j���� -��l��I <br />' � '�5 ' C � O , �-- I <br /> PROPOSEOUSEOfBUiI iNc IHEREBYCERTIFY?HATIHAVEREADANDE%AMINEDTHISAPPLICATIpNAND - <br /> �{��\� 2�� , KNOWTHESAMET02_TRUEANDCORRECT.ALLPFOVISIONSOFLAWSAND <br /> � OFDINANCES GOVERNING THIS TYPE OF WORK IVILL BE COMPLETED VJITH <br /> LEGAL�ESGRIPTIONOFPHOPERttISHOVINBELOWORATTACMFOURCOPIE51 WHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOFAPER�dITDOESNOT <br /> PRESULtE TO GNE Atl;HORIIY TO VIOLATE OR CP NCEL THE PROVISIONS OF <br /> �or B�oCK ov ANYOTHERSTATEORLOCALLAWREGULATWGCONSTRUCTIONORTHEPEF- <br /> FORMANCE OF CONSTRUCT!ON.THAT I AM AUTHORIZED BV THE OWNER OF <br /> THIS PROPERN TO PERFOR�1 THE WORK FOR NlHICH APPLICATIOY IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW ANO <br /> 296200 WAC. <br /> SIGNAiOPE FCO'lTFfLi0�0111�I111fORIZF04GEY1 �AT[ <br /> — � .�.`�,t���/��L L L_ Ll .�� �f�- <br /> PROJELTADORESS l \/ qPp�� nN ILv805iNc561iCfiN5L1bF4O�U51q�5511A!'C <br /> �� � � /(/L �/`. yl, � �v , <br /> PLUMBING MECHANICl.L <br /> �`' NO. TYPE OF FIXTURE OR ITEM FEE NO. IYPE OF EOUIPMENT FEE <br /> WATER CLOSET QOILEn A/C—A/H NOLG UN ITS—H.P. <br /> '�' BATHTUB �/ FORCED AIR SVSTEMS—&T.U�JJ M EA— <br /> '�� LAVATORV�WASHBASIN) UNITHEATERS—�T.U. M <br /> SHOWER CLOTHESORYERS <br /> ' ' KITCHEN SINKB DISP. VENTILATION FAN <br /> � DISHWASHER FANGE HOOD <br /> 'v1 LAUNDRVTRAY ✓ WA'ER HEATER <br /> CLOTHES WASHER VdOOD STOVE <br /> �p�ryq� METAL FIREPLACE 8 CHIMNEY <br /> '�' DRINKING FOUNTAIN FIREPLACE ItlSERT <br />� '�' FLOOR DRAIN HEAT PUMP <br /> � BACKFLOW PREVENTERS ✓ GAS PIPING _ <br />• ' _ ROOFDRAINS—RAINLEADERS EXHAUSTFAN <br />� � SINK(SERVICE—BAR.ETC.) ___ <br /> I1 1_' _ — — <br /> � <br />' _ _ <br />, i�j SUB TOTAL 5 — - -- SUB TOTAL _ 5 �S _ <br /> _ PERMIT 5 PEP�AIT 5 � <br />� TOTAL FEE 5 TOTAL FEE S � <br /> FFONiS[TBACH {iEARSEiBACN SIpES[1pAGK PIANCHECKNIIMBEP FEE PECEIFINO. <br /> 3 yo9/ <br /> uSEzar�e �ornne- vacnursrte FEES VALUATION FEE <br /> �res o rvo <br />� BUILDING <br />� T'PEOFCONST. OGCC' �.JYGPOUP NOOFOWELI.INGl1NIi5 -- - --- — —� <br /> nuowae�EiRCtUn: PLl1MBING <br /> 52EOF6LDG NO.OFSiOFIES 651AL. OCCLOAD ' <br />� ❑r MECHANICAI �O <br /> i �H <br /> NEiGMTLIMIiAiION OTHER <br /> FIRESPPINNLERSREOUIFED ❑YES il NO $TATE BUILDING SURCHARGE � <br /> il STATEENERGVSURCHAPGE <br />' APPLICAiIONACC.BV FLANSAPPR�T _- <br /> Pl1BLIC WORKS <br /> TOTAL <br />