Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />APPLICAJ-tON FOR CONSTRUL,4I0N <br />PERMIT p R u n <br />D �eJAN 22 �gg� <br />J�'1lkc�t qQ r C4 <br />TO BE COMPLETED IN INK- PLEASE PRINT CRITY OF EVE -RE TT <br />MAIL ADORE8S Cny LAR �♦ PHONE /�[�� �G���� <br />AKCNI TONER _ _ % A N/�s C`l��E'T-i {� Cll;a LAt-22D- 'J s — (as . <br />us-a- <br />MCi:ItJi�R�t yKT�•�►D I -IV1LL -EZS�. PHONE LICEN A <br />CITY <br />RUMMNO CONTMCTOR � 3w Ave StA _ gfdf?Sdt 7bZ-33►� M�CKwli ik:lLNo <br />D WDRN <br />❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION `D❑ACW [RSONOND/P ONE NDSERT BUILDING RE�LOiCATION <br />NANT WRFCEMENT ORINTERIpI REMODEL ONLY- <br />iV A•Y IAE <br />LOT BLOCK OF <br />ROOF DRAINS — <br />JEE111LXTl[A-L i AC <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTI NG OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br />FORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE OWNER OF <br />THS ANID PI RCOMPLYTNTHR THEMTHE STATEWORK FOR CONTRACT+ORSHLAW 182TIN IS MADE <br />7ORCW AND <br />206.200 WAC. <br />54ONATUAEOFCONI CTOR ORAUIHOROED AGENT DATE <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT <br />NC — NHNDLG UNITS— M.P.12, <br />FORCEDAIRSYSTEMS—BT.U. M <br />UNIT HEATERS—BT.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />_ RAN <br />GEIIOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT _ <br />_ HEAT PUMP <br />GAS PIPING <br />FXHAUSTFAN <br />----- SUBTOTAL <br />TOTALPERMITAIT <br />t <br />TOTAL <br />FEE <br />IL FEE E <br />pLAN CHECK NUMBER <br />reE�qs]2 <br />[CIIR NO. <br />ACK BIDE SETBACK <br />VACANT BILE <br />FEES <br />VALUATION FEE <br />O YES D NO <br />BUILDING <br />/q -- <br />;-GROUP NOOFOWELLINO UNIIB <br />- <br />D <br />PLUMBING <br />-- <br />)RIE9 BSMr occ LOAD <br />MECHANICAL <br />uY <br />❑N <br />NEgNT LIMItATION <br />OTHER <br />STATE BUILDING SURCHARGE <br />NO <br />STATE ENERGYSURCHARGE <br />P^By ` <br />PUBLIC WORKS <br />/) <br />LO�� <br />TOTAL <br />1 <br />