Laserfiche WebLink
� <br />APPLICATIG.1 FOR CONSTRUCT.JN PERMIT � <br />� TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />sm� <br />BUILDING DEPARTMENT HEATING SYSTEM: �GAS ❑ ELECTRIC U � <br />259-8810 <br />DEMOLITION COMBINATION BUILDING V MECHANICAL PLUMBING SIGN <br />ONMER M�II�DORE55 CITY ZIP PHONE <br />�Jo ►+N (3A-�2oN So 3-�� °''''�T s w � vrLr �if 98 d� 3 3'-f7 —o � 31_ <br />TEN�NT M�II�DDRESS CITV IIP PHONE <br />S C�.fxt c•-o C� oV ¢. <br />APCHITECTORDESIONER M�Il�U0RE55 GTY ZIP PNONE <br />6ENERILL CONTRIIGTON MAII �O�RE55 CITV ZIP PNONE STATE LICENSE • <br />MECLHQ"IIL"Q,, �C,ONTH�CiOR MML ADDRE55 CITV ZIP PMONE ZSZ� S7�TE LICENSE • <br />�T�// l /%�L�(,�f'I/C 4-i� �0 / -Lc� mC�I'C,I-tJ (�/01a �]A �GcX�tC� �%�201 33/7 S►+'IMECI �Ko99� <br />PWMBIN6CONTRRCTOR MR�L�DDOE55 CITV 21P PHONE STATELILENSE� <br />'V i,NEW V ' ADDITION �TERATION REPAIR <br />f.ONTP�CT ONIf.F OL WORK �. i O DO I��^� � i <br />OESCRIBE VIORK AND SIXI�RE <br />O <br />PROPO ED USE OF BU�l�INO <br />LE �ESLRIPil01lO PPOPE <br />LOT B�OCK <br />NO. <br />WATER CLOSET <br />BATHTUB <br />LAVATORV(WAS <br />DEMOLITION WOODSTOVE/FRPL INSERT � BUILDIN� RELOCATION <br />CONTlLT PERSON �ND PHONE NO <br />- �1(ty` "i - 1 d 1 / <br />i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE THUE AND CORRECT. ALL <br />fY �SNOWN BELOW OH RTTRCN FWfI GOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW fiEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSiPUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO r'ERFOFM 1�HE WORK FOR WHICH <br />APPLICATION �S MADE AND I COMPLV WITFi THE STATE <br />CONTRACTOFS LAW 1827 RCW AND 296200 WAC. <br />8 DISP <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNiAIN <br />FLOOR DRAIN <br />BACY.FLOW PREVENTERS <br />SINK <br />FOR OFFICE USE ONLY: <br />FRONTSETBACN REAP; <br />S12E OF 9LD0 <br />OCCUP�NCY lW0 <br />REASON FOR SPRINNlE�S <br />INT�ME BV <br />LOi AREA <br />1YPE 01 CONSI <br />FEE <br />SU9 TOTAL $ i <br />PEHMII E <br />TOTALFEE S <br />SIDE SETB�CN <br />WC�NT SIiE <br />�Np acuwxcr rwaovrturocvrns <br />GNWO <br />OF STOi11E5 BASEMI <br />ESPRNNLERSREO'0 HEIGHT <br />VlANS <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COOE IS 3105 <br />x �.u.a.aM � ,QC.Q��.� B -2 �/' `/ z <br />saM+iunr �. ..� _ � o..E <br />FORCED AIR SVSTEMS—B.T.U' <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />AD�ITIONAL PLAN CHECK <br />SPRINNLER <br />STATE BUIIDINa SURCHAFGE <br />PUBUC WORKS <br />TOTRL <br />E.A. <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />necEirrrro <br />