Laserfiche WebLink
� ,..., <br />APPLICAT��I�i FOF; CANSTRUCTI��iN PE�MIT everett <br />fhe Eva�g�oon TO BE COMPLETED IN INK--PLEASE PRINT � <br />CITY OF <br />everett � HEpTING SYCTEM• �� GAS ❑ ELECTRIC ❑ <br />. � <br />BUILDING DEPARTMENT -- <br />259•8810 <br />❑ DEMOLITION I I COMBINATION I I BUILD!NG <br />OWNEP MAILADDRESS CITY <br />��'D� C� � �S[c�A�ts ;'�O���v�4��J,� <br />TENANT M�ILA00{�ESS CIiY <br />s�l�t�l^ °� Ct�,O J �i�ll-9-tti�.- <br />AHCHITECTOflDE51GNEF MAILAODRESS CITV <br />L'� �GG �es�qnr /�4�0 ��os u�, yn7 L,�! 1 <br />r.FUFRAI tnNiBACiOR MAIL�OORE55 _ CITY � <br />I l MECHAS�ICAL <br />Z�p PHONE <br />3� <br />ZIP PHONE <br />ZIP PHONE <br />� �71 <br />ZIP PHDNE <br />' s� <br />ZIP PHONE <br />�O PLUMBING ❑ SIGN <br />-_ g! �a <br />`—l[J�D�� NSE n <br />• '�/ 75` <br />UCENSE � <br />PLUMBINGCONTRACTOR MAILADDf1E55�/_ v3� �,��{r��L CITY ZIP PHONE LICENSEN <br />cSGfJ/Q�V.50/�( /%1C'lfiA77lC�1L �v o /�� ��L��g�`o�� 911z23 �.�.�=7'�7i 5cr�.9��-�d�z � <br />�� CLASSOFWOFlK <br />� ❑ NEW J�1 ADDITION I] ALTERATION I� I REPAIR I 1 DEMOLITION I I WOODSTOVE/FRPL I�SERT ❑ BUILDIVG RELOCATION <br />� �J CONTAC' PERSON AND PHONE N0. <br />. CONTRACT PRIGE OF WORK /�r/ O D <br />� DESCHIBE WqRK PND SOUARE FOOTAGE INVOIV[0 � <br />i <br />PROPC <br />IEdAL <br />�or <br />i — <br />i <br />OF PFOPI <br />BLOLN <br />NO. TYPE OF <br />WATEF CLOSET <br />SFIOWER <br />KITCHEN SINK 8 OISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />FLOOR DRP <br />BACKFLOW <br />ROOF DRA6 <br />SINK (SERV <br />� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�'� APPIICATION AND KNOW THE SAPAE TO BE TRUE AND CORRECT. ALL <br />voe�owonnnnc�+FouRcoriEsi PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 REGULAT'NG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFlTY TO PERFORM THE WORK FOR WHICH <br />APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGNATUREOFCONiPACiORORAUTHORIZEDAGEhT DATE <br />) ��G`/ �/ ` � v/G� <br />,. _ _ /. APPLICAN75 CITY DUSINE55 LICENSE NO. ANO BUSIVESS NAME <br />OR <br />PERMIT <br />TOTAL FEE <br />FEE NO. TYPE OF EOUIPMENT <br />i A/�A/HNDLG UNITS—H.P. <br />� FORCED AIR SYSTEMS—B.T.U. M <br />—;— UNIT HEATERS—B.T.U. M <br />� CLOTHES DRYERS <br />; VENTILATION FAN <br />flANGEHOGD <br />! WATER HEATER <br />METAL FIREPLACE ! <br />V FIREPL4CE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />ou <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REABSETDACK SIDESETB�CN PLANCMECKNOfABER <br />. USE ZONE l0T AREA �ACr1NT SITE PEES <br />BUILDMCa <br />� TYPEOFCONiS.ALLOWA6LE iYPEOFCONSLACtUAL 04urAvcv xoAfVNRUxGuxrts <br />' �AWP PLUMBING <br />�, SIZEOF�LDG. NO.OFSTORIES BASEMENT MECHANICA� <br />OCCUPANCVLOAD FIfiESPFNNLERSBEO'D NEIGHTIIMIiATION AD�ITIONALPLANCHECK <br />OTHER <br />REASON FOR SPRINNLERS <br />STATE BUILDING SURCHARGE <br />INTANEBY PIANSAPPROVEDOY CITYOFEVERETT PUBLIC�YO?KS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />,.-.,,,;�:.,.-,_ , .. . . ... . .. ..... .. . ... .: . . _ _ _. . _ <br />. . , .... ... ..�.:.: . _ . �,. <br />SUBTOTAL $ <br />PERMIT S <br />TOTAL FEE 5 <br />NO. <br />� <br />/� <br />i <br />i <br />i <br />i <br />� <br />' o ; bD <br />