Laserfiche WebLink
� <br /> ; <br /> APPLIC�.i ION FOR CONSTRI..:T10N � <br /> " PERMIT <br /> :�e Eveqreen ' <br /> GTY OF °������ <br /> everett e , <br /> . BUILDING DEPARTMENT <br /> 259•88�0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> ��{.�1 GNN[H MAIIADDRE55 PTY ZIP %fONE <br /> �-1/�r� �r��u � Cc; y/,��P�e '1�Z0/ <br /> Q x .TENANt MPILRO RE�S `� LITV / ZIP PNDNL <br /> �y y �7v�t,n r ictai�.��'��ec� <br /> M� � CNREGLOPpC516NEF M��L�DDFE55 CRV ZIP ?NO�E <br /> y i-+ <br /> �y � GEHER�LLON �L,Ty P MARADDPE55 LIIY Z�P PH011E LICENSE• <br /> °N � 'S k'O�Gi'C,'� 'r�P'}'��(5Fs I�O:Z 1tiur D/ �'��e �BZD �i�'y3SS� <br /> W N MLCNANI�/.LCONTRI�GTOR MAILAOONESS CIiY 21P P� UCENSE� <br /> ryp�� <br /> V!O � P 01N;i CA iR�LtOR M�It�D�yrlq� QTY ZIP PMONC �y l .ENSE• <br /> y � ! �"��/ U oZ� �/OCJ ��w� <br /> �� g ���saF� K <br /> �� n ❑ NEW �ADDITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDIN6PELOCnTIDN <br /> �y� TENFNTIMPRWEMFNiORIMERIpqpEMDOEIONLY WNiPGTPER50N�NUFMONENO I <br /> � CANiRA�iCqICEOfWpRK <br /> pM H 0�H�I E�WORNA $OUAREfODT�GEINVOLVED � <br /> O rp _ - <br /> H .(�-✓ �(� W1. I b'lA <br /> �y P O�— �Of BUILDING <br /> � � IHEREBYCERTIFVTHATIHAVE(7EADAIJDE%A1dWEDTHISAPPLICATIONAND <br /> �,�� KNOY!?HE SAME TO BE TRUE AND CORREL7.ALL PFOVISIONS OF LAWS AN D <br /> y i[nwoeCRlFiIOHpiPROPEN1Y15HOWNBELOWOHRTACMfOVRGOPIE51 ORDINANCESGOVERNINGTHISTVP[OFWORKWILLBECOMPLETEDWITH <br /> N'HETH@R SPECIFIEDHEREINOR NOT.7NEGRANT14GOFA PERMIT DOESNOT <br /> O U1 PRESUMETOGIVEAUiHORITVTOVIOLATEOfiCANCELTHEPROVISION50F <br /> . �ot B�ocK oc AryYOTHERSTATEORLOCALLAWREGULATIN�CONSTRUCTIONOATHEPER� <br /> FORMANCE OF CONSTRUfTION.TNAT I AM AUTHORIZED BY THE OWNER OF ' <br /> ' TNISPROPERTVTOPLRFORMTME ORKFORINHICMAPPLICATIONISMADE <br /> � AND I COMPLV WITH THE ST NTRACTORS LAW 1fl27 RCW AND <br /> 296200WAC� ��� iy�C <br /> sm � vin4cio ��4u aucon Eirt o�rE /�J r <br /> PPOJEQ�DORESS n ^ AP UCn 1 LILYBUSINE �`aVCC ' NO<NDBUSINC59NNMG I <br /> � 22 �l _ � � � <br /> ��1 PLUMBING MECMANICAL <br /> 1 ' NO. T'PE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE — � � <br /> � WATEflCLOSET�TOILET) A/C—A/HNDLGUNITS—N.P. _ <br /> BATMiUB FOPCEOAIRSVSTEMS—BT.U. MEA <br /> " LAVATORY(WASHBASIN) _ UNITHEATEFS—BT.U. M � <br /> SHOWER CLOTHESDRYERS <br /> 1�I KITCMEN SINN 8 DISP. VENTILATION FAN y <br /> '�1 DISHWASHER RANGE MOOD — <br /> LAUNDRV TRAV WATER HEATEF <br /> CIOTNES WASHER �NOOD STOVE <br /> 1�' UFINAL METAI FIREPIACE 8 GHIMNEV <br /> �� �FINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR ORAIN HEAT PUMP <br /> � <br /> BACHFLOW PREVENTERS GAS PIPING <br /> �' POOF�RAINS—RAINLEADEflS E%HAUST FAN <br /> '�1 SINK�SERVICE—BAR,ETC.) _ <br /> i <br /> ' ' — <br /> � <br /> ' ' — <br /> 1 ' SUBTO7AL S SUBTOTAL S <br /> � PERMIT 5 PERMIT S <br /> '� � -'� TOTAL FEE 5 � TOTAL FEE 5 <br /> FROHTSETBRCK FEANSEI&1CN SIpGSEtBACN MHCHEC1tNUMBEfl FEE PECEIPTND. <br /> use2oxE toreae� v�uHrsirE FEES VALUATION FEE <br /> ❑YES O NO <br /> BUILDING <br /> ttPEO�CONST. OGCUPANGYGFOUP NOOFDWELLIM 'RS — <br /> quow�etHet*UeL PLUMBING . <br /> 54EOFBLOG NO.OFSiDHiES BSMt OCGLO�D <br /> ov MECHANICAL <br /> [1 N <br /> HewHr�iuiunov OTHER � <br /> rinesruiHK�[nsneou�aeo ❑VE9 o NO STATE 6UILDING SURCHARGE <br /> STATE ENERGV SURCHARGE <br /> PPPL�CC BY PL,INS�PPR BY <br /> PUBLIC WORKS <br /> c� r� <br /> TOTAL �- � <br />