Laserfiche WebLink
APPLIC�+r ION FOR CONSTRI..:T10N <br /> PERMIT <br /> the Evergreen rverett <br /> GTY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MAILNDORE55 CIIV ZiP PMONE <br /> �' �v��C�i����ra� I�'csp�-�'o.�� ���"'`�Colh�i '�'�, �mc � �t� 98ao�— I147 <br /> TENRNi 1/� MAILApDRE55 CIT� 21P PHON[ <br /> � ;=t�c<,�"�<. I�orkb�u�e5f � . �<� �co_Q_, �c,i� c�lb � , ���r� �s�l 339- 3�;�� <br /> 1 ` ��—� _ ITY ZIP FHONE <br /> RRCNITEGTOROES�GNER M�ILAVR•coo � �� � <br /> � �U-I�is-r ��s���ti ���. ���20 �"��5 . Sc�cct�(e 9b'�� 7��� - i <br /> GEN �LCONTRALTOR MAILA�ORE55 CITY 21P CNONE LICENSE• <br /> � �7�a l �til. �C� I�X�X �'J('� �� ��-����—�;�ENSE. <br /> MELN�NIGLCONTRAGTOR MRR DORE55 7 � _ ,. � /��^ I O -- <br /> lr7� %/ • 'C " / A <br /> S�s�-Lb ) CJ1 /V <br /> PLUMBINGCONTR�QOR MAILADORESS GIiY 21P PNONE LICENi.E• <br /> CUSSOFWORK <br /> ❑ NEW ❑ ADDITION � A�TERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> S y. GONTACi VERSCN ANO PHONE N0 <br /> TENANTIMPROVEMENTORINTERIORREMODELONL G � �n�L,��,� ��,��sr �a3-// -7 <br /> ✓ <br /> � CONTP�CiPR10EOFWORK , � � ��� <br /> pESCRIBEWORRRND50UPREF00TAGEM ED „�� /n <br /> x _ eu� . . � _ .,, �� — <br /> i � 1 u, � <br /> a oroseDus OFBUILDING IHEREBYCERTIFY'HATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> \, / ���/G� KNOWTHESAMETOBETAUEANOCORRECT.ALLPROVISIONSOFLAWSAND <br /> J' � ORDINANCES GOVERNING TNIS NPE OF WORK WILL BE COMPLETED W�TH <br /> LEGPLOESCRIPTIONUFPROPERtVISHOWNBELOWORRTTRCNFOURGO'IES7 yyHETHERSPEGIFIEDHEREINORNOT.THEGRANTINGOFAPERMITDOESNOT <br /> PRESUME TO GIVE AUTHORIlY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �pr B�ocK or _ ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUGTIONORTHEPER� <br /> FOAMANCE OF CONSTRUCTION.THAT I AM AU'HORIZED BV T��E OWNEF OF <br /> AN1D IRCOOMP YTWITHRTOHEMSTATE CONTRACT�ORSHLAWL1B2t7�RCW AND <br /> 296200 WAC. �_ Q Q� <br /> SIGNATUAEOFCONiRACiOROFAUTHORIZEOPGENT DATE ) �J <br /> A ZIA//�1 / l. .�f"�1..�(i(✓�1 <br /> ��101 / L�� - <br /> PROJECTAppRE55 PPPL ANiSCrtYBU5iNf55LICEN56'NOANOBUSWESSNaME <br /> �( � f�� � ,� �V,e' I,�U/�' <br /> MECHANICAL <br /> PLUMBING <br /> Np, TVPE OF FI%TURE OR ITEM <br /> FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSETITOILEn A/C—WHN�LG UNITS—H.P. <br /> FORCED AIR SYSTEMS—B.T.U. M EA <br /> BATHTUB <br /> LAVATORY(WASH BASIN) l�N1T HEATERS—B.T.U. M <br /> CLOTHESDRYERS — <br /> SHOWER — <br /> KITCHEN$INKB DISP. _ VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> WATER HEATER <br /> LAUNDRYTRAY WOOD STOVE <br /> CLOTHES WASHER <br /> — METAL FIREPLACE 8 CHIMNEY _ <br /> URINAL <br /> FIREPLACEINSERT <br /> �RINKING FOUNTAIN <br /> HEAT PUMP <br /> FLOOR DRAIN <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL 5 <br /> SUBTOTAL S <br /> PERMIT 5 <br /> PERMIT S 7pTAL FEE 5 <br /> iOTALFEE 5 PUNCN CKNIIMBEP FEE �.,/-� NECEIPTNO. <br /> FRONTS[TBACH REFRSET6AGN SI�ESETBAGK �1� � L�I �L/�i q � � <br /> lSJ �— \ <br /> yACPNT5ITE FEES VALUATION FEE <br /> SEZUNE LOTRFER pyES LGNO �,/._ <br /> _� C� � � BUILDMG � <br /> �'� NO.OF p1YELLING UNITS <br /> ttPE OF W NST. OCCUPANGY GROl1P <br /> nuoWAe�EieCTun� � PLUMBING <br /> 7I_ �t� lj' "L <br /> SIZEOFBLDG. NOAFSTORIES U�Ai. OCGLOAO MECHANICAL <br /> Y 44 <br /> 3scn S� ❑ " <br /> MEIGMTLIMITPTION OTHER — <br /> FIRESPRINKLEPSREOUIPED YES � NO STATEBUILDINGSURCHARGE <br /> STATE ENERGY SURCHARG[ _ <br /> qPPL:C4T10N ACC.BY PIANS APPR_BV PUBLIC WO�KS <br /> �,�� � TOTa� _ � <br />