Laserfiche WebLink
APPLICATION F�R C4NSTR�;"CTION <br />PERNi1T <br />fhe Everpreen rvercll <br />CITY OF <br />everett � :. <br />BUILDING DEPARTMENT <br />259•88to TO BE COMPLETED iN INK— PLEASE PRINT <br />OWNEfl MAl1.A�DRESS CIIY ZIP PHONE 7jy'�_�'�fb�, <br />i� \ l \ ;� p <br />��4t c\ L�.'lC.7¢.�'1 �v.`� tiY� Z'�..�. isc�C9U E �.•�Zi _�<nt�� N�V 1e. Ct�6tb� �; <br />TENhNj� MAILAO�RL55 ,` <br />�(� �l "� l�c��, �Ve V,.,. -«\'�- \�v2�e� ��'Lc��( � <br />1�1� 'S^ l <br />�OCHREC70R�ESIGNE�7 MFIL�OORESS CI7Y 21P PHONE � <br />OENEPAL�� MAILA'1�PES5 CITY ZIP PHONE ��GENSEs ! <br />� I n �V'Y7C� <br />MEGMnNILRL TPACTOR MAILMOFE55 CITY 21P PMONE LICENSE• <br />/I,In • <br />n <br />a <br />. <br />CL�SS Of WOfiK <br />❑ NEW '� ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEAIOLITION ❑ WOO�STOVE/FRPL INSERT ❑ BUILOING RELOCATION <br />-- .7c7oQ—Le) <br />LOT�_ 6LOCK OF <br />PLUMBING <br />�O. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILE� <br />BATHTUB <br />LAVATORY (�''�ASH BASIN) <br />SHOWER <br />KITCHEN SINKB DISP. <br />�ISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS— RAINLEADERS <br />SINK lSERVICE — BAR, ETQ) <br />SUBTOTAL S <br />PERMIT 5 <br />TOTAL FEE S <br />ioNrsnn�cn nenr�serrnncn sic <br />� ` <br />iEZONE LOT EA \'AI <br />� � � <br />k�� 1 <br />NO.OFS OflIEZ BSM <br />/ OY <br />( F�N <br />FIBE SPBINHLEpS BEOW R'. n <br />1 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOWTHES�METOBETRUEANOCORRECT.ALLPROVISIONSOFLAWSAND � <br />OR�INANCES GOVERNINCa THIS TYPE OF WORK WILL BE COMPLCTED WITH <br />WHEfHERSPECIFIEDHEREINORNOT.THEGRANTINGOFAPERMITDOESNOT . <br />PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPROVISIONSOF , <br />ANY OTHER STATE OFi LOCA� LAW REGULATING CONSTRUCT:ON OR THE PER- <br />FORMANCEOFCONSTRUCTIDN.THATIAMAUTHORIZEDBYTHEOWNEROF , <br />THISPROPERNTOPERFORMTHEWOFKFORWHICHAPPLICATIONISMADE . <br />AND I COMPLY WITH THE STATE CONTflACTORS LAW 18.27 RCW AND <br />296200 WAG 9/�� . <br />SIGNPTUREOFCONiRRCTOFOFAl1TNOf1REDPGENT OATE <br />APPLI�N�ISNESSl�SENO.A1NBt1 ESSNAME ���'S� <br />MECHANICAL <br />NO. <br />UNIT HEATERS— B <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHO00 <br />METAL FIREPLACE! <br />FIREPLACEINSERT <br />HEATPUMP <br />BUILDING <br />iWEILING UNITS <br />_� PLUMBING <br />A� MECHANICAL <br />Y /� <br />LIM�ir1TION OTHCR <br />i <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />— H.P. <br />— B.T.U. IA E0. <br />M <br />TOTAL <br />Fct <br />T � <br />—.:.�..T�.— ... , ... -..,... ,.... .._ ... �:r . . _ . . . . . <br />� .. <br />.�� y' , <br />