Laserfiche WebLink
APPLIC..�ION FOR CONSTRI.�:TION <br /> PERMIT <br /> the Everpreen rvrrel[ <br /> GITV OF <br /> everett e <br /> BUILDING DEPARTMENT <br /> 25�•8810 TO BE COMPLETEU IN INK— PLEASE PRINT <br /> OWNER IAAILPDDBES$ QTY ZIF PMONE <br /> -v�,.c--r i C��=n� kl�sp»�l+- ('l- i='�ox II�l7 G��r�rT �SZo6 ��S - C.� �K� <br /> TENANT MAiLA00RE55 CITY 21P PHONE <br /> AR�NITEGTOHOESIGNEP AIAILFDDRE55 CITV ZIP ✓HONE <br /> GENER�LCONTRPCTOR MAILPDOFESS GITY 21P PHONE UCENSF• <br /> MECM�NIGRLCONiRACTOR MRILAO�RE55 CITY ZIP PHONE LIC[NSE• <br /> PIUMBINGCONTRACTOR MRILAD�RESS diV 21P PMONE LiC[NSE• <br /> )1j,'�C�xnt <br /> MFluxnii��� f,vu�' C.� �77�7 ��c'�'� �r St.J Se�r'rt� ��si�� 7C�-`aqc� zqesy <br /> CUSS OF WORK <br /> ❑ NEW �_ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TENRNT IMPROVEMENT OR INTERIOH REMOOEL ONLY CONTNGT PEPSON PND PNONE NO. <br /> CONTR�GT PRICE OF WOPK,� /�j�v�� <br /> DESCRIBE WORK PND SOUARE FOOTRGE INVOLVED <br /> /�L' r�7l�iiNC�. — <br /> PROPoSED USE OF BUILOING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED TMIS APPLICATION AND <br /> K�IOW THE SAME T^"'"+UE AND GORRECT.ALL PROVISIONS OF LAWS AND <br /> LEGaLOESCRiaT10NUFPPOPEnnISHOWNBE�OWOennAGHFOURCOVIE51 ORDINANCES�'� ' '� ^�STYP[OFWORKWILLBECOMPLFTEDWiTH <br /> WHETHERSPE'. � � 9NOT.THEGRANTINGOFAPERMITDOESNOT <br /> PRESUME TO G'1� � t� � � TO VIOLA7E OR CANCEL THE PFlOVISIONS OP <br /> �pT e�ocK or ANYOTH�RSTAi, r.� ._AWREGULATMGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSI RUCTION.THAT I AM AUTHORIZF.D BV THE OWNER OF <br /> THIS PROPERN TO PERfORM THE WORK FOR WHICH APPLICATION IS MADE <br /> PND I COMPIY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WAC. <br /> SiGNRtUREOFCONTPACTOBORAULHORIZE�AGENt OATE ���Q/��� <br /> �i �i 1� I U� Cu�n'ra.�� X'I7Zc% —� —,� .��9 <br /> PROJECTApORE55 {/--����-�_ APPLIGANTSCITVBUSINESSIIC�NO.ANDBU51 NAML <br /> i.3Z1 Gc�l�Y A1�= � FL�>�2- � _ �:�v �_D t� - C.�- " o <br /> PLUMBING MECHANICAL <br /> NO. TYPEOFFIXTUREORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> � WATERCLOSETITOILET) A/C—A/HNDLGUNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—BT.U. M EA <br /> —�'j LAVATORVIWASHBASIN) a-Lj UNITHEATERS—BT.U. M <br /> � SHOWER O CLO7HESDRVERS <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV WATER HEATER <br /> CLOTHES WASHER WOOD STOVE __ <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP _ __ <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK�SERVICE—BAR,ETQ) <br /> 1 GiR'.GVI../�TIC�I /�J � '. <br /> �� 1 '�- <br /> SUBTOTAL 5 SUBTUTAL 5 <br /> PERMIT S _ PERMIT 5 � <br /> TO'fAL FEE 5 U W TO7AL FEE 5 <br /> FRONTSETBAGK REARSEf�RCN SIOESETBNCN PLANLHECNNUMBEB FEE FECEIPTNO. <br /> USEZOnE �otnA[a VncnN*SrtE FEES VALUATION FEE <br /> G YES ❑ NO <br /> BUILDING _ <br /> TYPEOFCANST. OCCUPANCVGROUP MO.OFDWELLINGUNITS - - <br /> ALIOW�BLfJRGTUAI PLUMBWG <br /> 512EOFBLDG NOAFSTORiES BSMT. OCG.LOAD MECHANICAL GT �J� <br /> ❑ V <br /> ❑ N — <br /> r1EiGMTLIMITPTION OTHER <br /> FIRE SPRINKLERSREOUIREO ❑YES ❑ NO STATE BUILDING SURCHAfiGE <br /> STATE ENERGY SURCHARGE <br /> qPPL'GATIONACCBY P�ANSRPPR.BY PUBUCWORKS <br /> Tora� s� <br />