Laserfiche WebLink
[�1 C��7 y <br />,o�x <br />>yw <br />y �H <br />� H� <br />o xo <br />�r� <br />VJ H <br />L'1 0 � <br />H t7 <br />OH <br />'� C� C7 <br />H^ L�7 O <br />y, V �] <br />� H� <br />HH <br />g� <br />Cq] C7 � <br />[+J � C7 <br />Z H vr <br />H O V� <br />-E`��, d 7"y`'} <br />, APPLIC:�►TION FOR CONSTRt�CT10N <br />PERWIIT <br />the Evergreon <br />GTY OF <br />everett <br />BUILDING DEPARTMENT <br />. <br />Tn [iF f`l�MPI FTFfI IfJ INK — PLEASE PRINT <br />SiL��ISE���cE �cr�Fc:nES tNC. 9117-I�'li Sr/-h'�•h1E QC��MJ7Ut� wA• 9�,e�y2 �,P,l-a2C�l , <br />GENERPLCOMPAGTOR M1IAILADORE55 CpY ZIP PNON[ LICENS[+ <br />MECNPNICALCONiPAGiOR 6�AILPOpfIL55 GIiY ZIP PIIONE LILENSE• <br />PLUh�O�GCONiliPGTOR 1JAILApORE55 CIIY ZiP PIIONC LICENSE <br />a",�'n/s`�oFw'-�o�'4T�L14`nOM' fa'JE e/F I�I1". I�a,1AM. 1/In�1.l�:E�Slf�til. -- <br />�O�NEW ❑ ADOITION ❑ ALTERATION ❑ flEPAIR ❑ OEMOLITION ❑ H'OODSTOVE/FRPLINSERT ❑ B111L01NGPELOCATION <br />CONTPACT PRIGE OF WORK <br />LOt 9lOCrc___ OF <br />PLUMBING <br />No. f'— <br />DISHWASHER <br />LAUNORYTFAY <br />CLOTHES WASF <br />DFINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PFEVEM <br />onnv nonuac _ oeu <br />� — �') P <br />� <br />ITEM <br />5 TOTAL S <br />PERMIT 5 <br />TOTAL FEE 5 <br />iSETf1ACN S�DESEIDRCH <br />rOl `� (1 <br />I <br />I.REA �ACANLSIiE <br />❑ YES u" NO <br />❑PANGYGROl1P NO.OfpWELUNGUNI <br />JFSIOR�ES BShli OCCLOAO <br />❑Y <br />❑ N <br />SPPINNLE95REOUIHEO ❑ TES ❑ NO <br />C� <br />I HEREBYCERTIFYTHATI HAVE READ AND E%AMINEDTHISAPPLICATION AND <br />KNOW THE SAMETO BETRUEANDCORRECT.ALL PFOVISIONSOF LAWSAND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COIAPLETED W�TH <br />WHETI1Efl SPECIFIEDHEREIN OR NOT.THE GRANTINGOFAPEFMITDOES NOT <br />PRESUME TO GI1'E AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATI NG CONSTRUCTION OR THE PER� <br />FORMANCE OF CONSTRUCTION. THAT I A1.1 AUTHORIZED BV THE OWNER OF <br />THIS PROPERiV TO PERFORM THE WGriK FOq W HICH APPLICATION IS MADE <br />AN7 I COMPLY WITH THE STATE CONTRACTORS LAYJ 1827 RCW AND <br />2�6 2�� <br />swr+ aeor,o�+rna +oec +anizeoa o e Cj�q <br />�� C , �/ � 2.. . 2 � i %.fi° / <br />� <br />APPLICANiS CIIY �US�NE55 LICEYSE NO AHD 9051NE55 N4l1E <br />MECHANICAL <br />NO. TYPEOFEOUIPME <br />A/C — A/H NDLG UNITS — H.P. <br />FORCED AIR SYSTEMS— B.T.U. <br />UNIT HEATERS— B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />TOTAL FEE <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCMARGE <br />STATE ENERGY SURCHAI7GE <br />PUBUC WORKS <br />iOTAL <br />S <br />5 <br />FEE <br />FEE <br />