Laserfiche WebLink
mo e�ore,oa� <br />CITY CF <br />everett <br />BUILDING DEPARTMENT <br />259•8d10 <br />(,;�:':� <br />APPLICI�:��ION1 FOR CONSTRI� �TIQM <br />PERMIT <br />TO DE COMPLETED IN INK— PLEASE PRlNT <br />cvereu <br />� <br />OWNER MAILR�ORE55 GIIY ZII' PIIONE <br />/�,q,�'r'l7oN �ASSO�C. 97-?S 3�+'AUL' �(/.L'. SE.¢ %�'//S S�7-J0�%S _ <br />TENRNi MNLAD�PE55 CIiY ZIP �IIONE <br />FJoci�trG 77/0 �V�r�rz�L� �w�9y �vF�t7T 9dao3 <br />ARCIIIIEGTOFOESIGNER MhILR00RE55 CIIY 21P PMONE <br />GENERALCONIRr1CIOR 61AILADORE55 CILY IIP PIIONE L6ENSE• <br />MECN�NIC/•LGONTflALTOq MAILAO�fiE55 CITY ZIP FMON= LICCNSE� <br />PIUMBiI:aCONiR4CTOR MR:/�011[95 C�1Y ]IP PIIONE LICENSE� <br />/✓iilc.�rnv,v�o •�ricacf�2 77/7 .D�T,ea�T Sr.v 5'�'i 9&�0� 7G3-S4ao�'�a�.� <br />cuss ar wonK <br />❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJPRPL IHSERT ❑ BUILDING RELGCATION <br />wORk�=��_ %�C <br />T!-.!'AM' �M'��aVEHEti7" [NV <br />o FFicE <br />LEOAl0E5CFIPiION UF PNi <br />LOT CIOGN _ <br />G� a55Roo�n <br />OF <br />OJEGTAOORE�S <br />� �io E (iC/2[; 2 EE�L1 <br />PLUMBING <br />NO. TYPEOFFIXTUREOHITEM <br />K'ATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINKB DISP. <br />DISHWASHGR <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIPI <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS— NAINLEADERS <br />FINKISERVICE— B:.R, ETC) <br />SUB TOTAL <br />PERMIT <br />TOTAI F[E <br />❑Y <br />❑N <br />FIHESPPINKIE(i5PE0UiRED ❑YES ❑1 <br />o•� � <br />$ <br />S <br />O VES ❑ NO <br />I H[REBY CERTIFY THAT I HAVF READ AND EXAMINED THIS APPLIC�TION AND <br />KNOWTHESAMETOBETRUEANDCORRECT.AL� PROVISIONSOFLAWSAND <br />OFi01NANCES GOVERNING ThIIS TYPE OF WORK WILL BF COMPLETED WITH <br />Wh!ETHER SPECIFI[DHEREIN OFl NO1.iHEGRANTINGOFA PERMITDOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATC OR CANCEL THE P(iOVI510N5 OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING GONSTRUCTIOI I OR THE PEFi- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TfiE OW NER OF <br />THIS PROPEI7N TO PERFORM THH\\'ORK FOR N"11CH APPLICATION IS IdADE <br />AND 1 COMPLY WITH THE STHTE CONTRACTORS LAW 18.27 PCW AND <br />296290 WAC. <br />SIGNAlUBEOfCON7PACTOfiOP/.UtHOR12ED�GENT OAiE <br />�__L==LJ'.�/1Gc,t/�- /�A/�+�.0 ��'�— <br />APPUCANLS GIl Y �USINESS lIG[NSE NO. AND 9USINE55 NAME <br />MECHANICAL <br />NO. TVPE OF E <br />GT' A/C—A"INDLGUNITS <br />-f FORCED AIR SYSTEA75 <br />UNIT f:EATEflS— dT.U. <br />R�NGEHOOD <br />WATER HEATEfl <br />WOOD STOVE <br />METAL FIREPLACE & <br />FIFiEPLACE INSF�RT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />— fl7.11. M <br />M <br />SUBTOT�,L S � <br />PERMIT 5 � <br />TO7^1. FEE 5 <br />�LANCHECNNUM6EF FEE TECEIPTNO. <br />FEES VALUATION PE8 <br />ew�oiNc <br />PLUMBING <br />MECHANICAL II�� �l� <br />OThIER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />