Laserfiche WebLink
,- . .. <br /> APPL�CATIQ"� FOR CONSTRUCT'"1N PERMIT � <br /> TO BE COMPLETEO IN BLACK INK—PLEASE PRINT <br /> BU�I OING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> 259•8810 <br /> I 1 DEMOLiTION Cl COMBINATION [7 BUILDING ❑MECHANICAL ❑PLUMBING f i SIGN <br /> OYMER l /) MMLA�DRE55 LITV ZIP PNONE <br /> ' �i r �D 4J75" �r�7 ,�'��5'�� c� - 3/n9% <br /> TEN�NT �L�O�RESS CITY 21P PNONE <br /> ��l ��/��Lc' r�-f.(no� <br /> ARCMITEGTORDESIONC� MAII�DDNE55 C�i� IIP PMONE <br /> OENERALCONTF�CTOP MARADDRE55 CITV 21P P�IONE STATELICENSEt <br /> MECHANIG0.CONTR�CTOP M�RAUDf1E55 GITY 21P PMONE STRELICENSE� <br /> PLIIMB CONTR�GTOR M�ILADDRESS qTV 21V PNONE STATELICENSE� <br /> /�`-n <br /> GMlTPo1GT PRICE OF WORN <br /> OE6CRIBE WORN AND SW�RE FOOT�OE INVOLVED CONTACT VERSON ANO PNONE NO. <br /> 9 <br /> I HERE6V CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE F BUI nw APPLICATION AND NNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> � (�(/�d+1�� PROVIS�ONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LFOAIDESCRIP IONOFPHOPERTY�SNOWNBEIOWONATTAGN'WOLOPIES� WOHK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREINOR <br /> NOT. THE GRANTINO OF A PEFMIT DOF.S N0T PRESUME TO �IVE <br /> «T B1�" °F AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL U1W REGULATIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF COfJSiRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPEFTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADc AND I COMFLY WITH THE STATE <br /> P�PCEL T�N ID.NUMBER CONTRACTORS LAW 18.27 RCW AND A6200 WAC. <br /> CANSTRUCTION LO�N LENDER,�O�RESS,TELEPI IONE NUMBEH <br /> PR0.IECT ADORESS ebr���un w�[ <br /> � "1 �� .IiYBU NESSI�CEN5F1q <br /> C'�' <br /> P��s�� M ANICAI <br /> Np. TVpE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.TU. M � <br /> SHOWER ' CLOTHES DRYERS ! <br /> KITCHEN SINK 8 DISP ' VENTILATION FAN � <br /> DISHWASNER � RANOE HOOD ' <br /> LAUNDRV TRAV ; WATER HEATER '_ <br /> CLOTHES WASHER WOODSTOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOH DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENT"cRS ; GAS PIPIN6 <br /> ROOF DRAINS—RAINLEADEPS EXHAUST FAN ' <br /> � <br /> SINK(SERVICE—BAR,ETC� I <br /> — � � <br /> — � <br /> � <br /> SUB TOTAL S (�'3 ; SUB TOTAL S 'd'v <br /> PEFMIT S ,'1 C�r PERMIT S <br /> TOTALFEE S TOTALFEE S ' <br /> FOR OFFICE USE ONLV: <br /> FRd1T SETBACN NEAN 6E�B�CN SIDE SETBACN �l�N C ECK NIIMBER FEE NELEIVT NO <br /> S _S' _ <br /> u5E 20NE LOT�REA V�CANT SITE FEES VALUAiION FEE <br /> ❑ YES ❑ NO BUILDIN(3 ' <br /> ttR�iCONSf NOOFSTORIES tuuwn[r xOaoWFIUMtuNns <br /> GR0°o pLUMBIN4 � � <br /> SIIE OF BL00 FIRE S"RINHlERS Rt0'� BASEMENT MECHANICAL <br /> f=� VES ❑ NO �1 <br /> OCGUPANGY LOI1D FIRE Q�RM RE00 NEIQIR UMITRION ADDITIONFL PLAN CHECN � <br /> i <br /> OiHER <br /> RE�SON <br /> � STA7E BUILDING SURCHARGE <br /> INiANE BY PL�NS�PPROVEO BV CITY OF EVEflETT PUBL�C WORKS <br /> LOCAL SIILES <br /> o�?E TAX CODE IS 3105 T0TI1L �7 ; <br />