Laserfiche WebLink
� fN Everpreen <br />: �� CITY OF , <br />: everet� <br />BUILDING DEPARTMENT <br />259-8745 <br />/ .�.I ti <br />�::�Af�PLOCATION F ��;';R <br />CORISTRUCTION <br />P�RMIT <br />TO BE CUMPLETED IN INK- PLEASE PRINT <br />everetl <br />e <br />� ❑ DEMOLITION ❑ COMBINATION S(BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />pWry�q MAILA0�11E99 CITY ZIP PHONE <br />' �,.�,erz ��,'nr�� iioo v����u�� �� ��i aa3 -�y�� <br />eRCMITECiOR�ESIGNER E� ,�(���'r�llA0�RE55 CITY ZIP PHOHB <br />L��c� ,-rr��i_�rt Nag�c I� t�-si� St�`�t� g$r zz 32S '� 3 1�i 3� <br />� GENEfiAI GONTARCTOR MAIL N�OBE55 GItY ZIP PHONE LICENSE � <br />1 �KJI L�O�fiN <br />MECNRHIGLLONTRACiQq MAILAD�RE55 GILY IIP p11pNE LICENSE• <br />PLUMBINGLONfRACTOR M�IIAD�RE55 CITY 21P PIIONE IICENSE• <br />GvL <br />F <br />{ VRI <br />I � <br />! OE <br />f ` <br />US <br />NEW ❑ AODITION ❑ ALTERATION ❑ RENAIR L7 DEMOLITION ❑ WOODSiOVE/FRPL.INSEFT ❑ BUILDING RELOCATIO�I <br />�iION OF t5'ORN �COST OF MRiERIqLS PL115 LRDORI <br />] <br />7 «..,,� ����„�, � �..� ..� ..,,..�„� � � <br />LOi_BLOL1(_�OF_ <br />�c 2 <br />' �� 7 -Z8 -S <br />� .FPOJECTAD�NESS C <br />j L Q �� C✓���r�a./L�Gix/ <br />i, PLUMBING <br />NO. TYPE OF FI%TURE <br />� - WA7ERCLCSE7ITOILED <br />� BATHTUB <br />�AVATORY (Wnbll BASIN) <br />i SHOWER <br />� KITCHEN SINK 8 OISP. <br />� �I- DISHWASHER <br />� Lt.UNDRYTRAY <br />CLOTHES WASMER <br />I� WATLR HEATER <br />� URINAL <br />I DRINKING FOUNT.41N <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE?RUEAND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDIN�NCESGOVERNING THISTYPE <br />OF WORK WILL BECO\APLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO <br />GIVE AI�THORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY O7HER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE Cf CONSTRUCTION. � <br />SICaNAT11REOFCONTRACTOROR iH0171 EDAGENT DATE �•Z��S� <br />X �• <br />�� <br />PPLIGANTS CITY OUSWE55 UCENSE NO, <br />EA. <br />EA. <br />TOTALFEE SI I I I TOTALFEE SI <br />T!�IS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />UJEZONE n <br />1 � � (� <br />� TYPEOFCONST. <br />� � <br />SIZE OF OlDO. <br />� ���� SF <br />12�}-�SOo SP <br />OCCUPANCYGROUP <br />�'� <br />� APPLICFIION RCQ �Y PLAM9 CHEtiNED I <br />� JEF <br />� � �� / <br />� <br />VACANTSIIE <br />HS�ES OI�O <br />NO.OF DWELLINO UNITS <br />APPR.FORISSUANC <br />L _ c. <br />FEES <br />BIIILDI`!G <br />PLUMBING <br />MECHANICAI. <br />OTHER <br />PENALTY <br />TOTAL <br />PLAN CMELH FEE <br />FEE �8��a fiECEi°iN0 <br />VAlUAT10N FEE <br />��C-�L ��r..OLY <br />� <br />n <br />/OG 9 <br />T <br />I• <br />