Laserfiche WebLink
��y� <br />Oxlx <br />9Hf~i� <br />4 <br />H � <br />�H� <br />� H '�9 <br />V1 H <br />H <br />x <br />Oyd <br />H�g <br />4] V �p] <br />9HL*7 <br />4 <br />t HH <br />g� <br />N <br />C�CCn <br />� Q � <br />y0[yi� <br />ai � <br />��v <br />.. �y ;i: e''�: .: <br />� 1`;.'.iy � . <br />� <br />.=�lPPLI �ATIO�1 FOR CON�TRl,ICTION P�iRM11�' <br />everett <br />rhe Evergreen � <br />CITV OF <br />evere�i <br />BUILDING DEPARTA6ENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />f_I DEMOLI'ilON �: COMSINATION i_: 9UIlDING MECHANICAL PLUMBING SIGN <br />OWNER �M/AILPUDRESS CII" ZIP PMJNE <br />��„y�'�.��. _Jn�7'� I�CJn l��,e,:�� fl2•#ado f% �cl�o., l�e,�df 7:oS7 i7i3) -,7GG -k�iv <br />N�� MAILAOOflE55 J LITY 21P PNONE <br />RRCHRECTOR�EniG'. I.IARpDORESS CITV ZIP PMONC <br />GENEPALCONTFACT69 61AtLADDPE55 CITY ZiP PHOf1E LICENSEa <br />ldECH��,ONiRRCi.e� / MAILADDPESS CITY ZIP PHONE LICENSEx � <br />PLUMBIHGCONTFA TCR �IAllA0�fiE55 GiY ZIP PHONE LICENSEY <br />(,���ca��'��• n i3� ,�c o� 6 Ro cN.o.T ,e£, 4' )o�v G 6' i- i �,�i a� n c. � Pc �,F � <br />cussoFwoa .. <br />I.-i NEW ❑ ADDITION !__' ALTERATION �.�. ��: PEpqIR '. _I DEMOLITION i. ��. WOODSTOVE/FRPL INSERT I� I BUILDING RELOCAI 10N ' <br />'cf:ANTIMPPOVEMENiORINTER10HflEM00ELONLY I CONiACTPE?SON4NOPHONENO. � <br />J�'VTPFCT PqIC[ OF WORN: <br />OEcCFI9E WOFK �ND SOURRE FOOTAGE INVOLVE� <br />��l.uml��n _... <br />PpncO5ED�U/5ECFBUIt ING <br />f`�T�c — <br />.E .�.. OTeSCRIPTION OF PflOPERTY �SH01YN OcLOW OR ATTACH FOIIR COPIES� <br />L4T OLOGK _ OF _ <br />PqOJECTAODPESS _,_/ <br />�/MA 1 i .�„ n�. f� o i' /� <br />u7:N�2 <br />URINAL <br />I NEREBY CERTIFY TFI6T I HAVE READ AND EXAMINED THIS � <br />,:�°?UCATION AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL � <br />F'NCVISIONS OF LAWS AND ORCINANCES GOVERNING THIS TYPE OF � <br />WORK WILL BE COMPLETED WITH WHETHER SFECIPIED HEREIN OR '� <br />NOi THE GRANTING OF A PERMIT DOES NOT PRESUME TO G JE � <br />AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY ' <br />OTHER STATE OR LOCAL LAW REGULATING CONSTflUCTION OR THE � <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH , <br />APPLICATION IS MADE AND I COMPLY VJITH THE STATE ' <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. ��, <br />SIGNATUREOFGO:."RACTOfiOR�OTHORIZED"iENT �ATE �� <br />pP �i3CITY0USINESSUCE N .nj, USINESSNAhtE 'i <br />OP:TE!d FEE PIO. TYPEOFEOUIPMEN7 FEE <br />� ��D !VC—NHNDLGUNITS—H.P. � <br />�y ; FORCED AIR SYSTEMS—B.T.U. M E.A. '� <br />$y � UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS � <br />F'c�: rvi VENTILl.TION FAN � <br />PERAIIT S <br />TOTAL FEE $ <br />FqONiSETBAGH REAq5ET0ACN I SIOESETBRCK <br />USEZONE I LOTRREA <br />ttPE0FWN5iFLllNAOIE � iYPEOLLONSi.ACtpAL <br />SREOFBLDG. <br />OCCUPANCVIOPD <br />PEASON FOfl SPRiNHLERS <br />NO.OF SiOiiiES <br />FIRE SPRtMLERS REO'0 <br />[_'. YES :_7 NO <br />APPIICATIONACC.BY I PaNSAPPROVEOBV <br />RANGEHOOD <br />WATER HEATER '-� <br />WOOD STOVE _ <br />MET4L FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPWG <br />[XHAUSTFAN <br />SUB TOTAL <br />TOTAL FEE S <br />PlANC11ECHNUM6ER FEE RECEIPTNO. <br />VACANTSITE FEES <br />iJ YES I�.; NO 6uaoiNc <br />acurevcr rm orownuncuxrts <br />GaOUC <br />PLUMOING <br />BASEmErur MECHANICAL <br />: 1 YES i:-��, NO — <br />HEIGHTLIMITATION OiHEfl <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGe <br />CITY OF EVERETT PUPL�C WOFKS <br />LOCALSALES <br />TAX COUE IS 3105 Torn� <br />