Laserfiche WebLink
i <br />� <br />i <br />q <br />Jj�•�� fr�.t <br />. APPLICATIGr� FOR CONSTRUCTrbN PERMIT <br />� everett <br />�ry�� e <br />everett <br />BUILDINO DEPARTMEPlT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION I I BUILDING 1�MECHANICAL ❑ PLUMBING [J SION <br />OWHER IMILAOORESS � CITY ZIF PliONE <br />Z�P PIIONE <br />ARCNRECTONOEBIONER MA0.�ODRE55 CIiY ZIP PHONE <br />QpNTRAOTqi MAILADDRESS GTY ZIP PNONE UGENSEt <br />MECHIWICN.CONTMC70fl �j,�,�MLAM1ADORESS � GTY ZIP PIqNE �/L�ICE�N�S/E� �j}�.�/�• <br />�'111A6WOCONTMCTON� I/GI/¢LIIDOPES���,—'��CIT�v� �O� ��N��I L/W4lhLlJ� I.7 I'KJ <br />CU�98 OF WOnK <br />�'NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING REIOCATION <br />lcwwt ��rnovE�Nr oa <br />LEWlTRBCWPiqN Of 7Rd�Eq1Y (SIpWN BELOW dl AiTACH FWN <br />lAT __ BLOLK __ OF <br />LAVATORY <br />IAUNDRYTRAY <br />CLOTHES WASHER <br />DRAINS—HAINLEADERS <br />SUB TOTAL E <br />PERMIT $ <br />TOTALFEE S <br />FRONTSETBAGK RE�pSETBACN SIDESETBRCK <br />� <br />f USEZp1E <br />� rvee a coxsr. w�ow�eie <br />i 61ZF.OF BL00. <br />1 <br />OCCUPANCY�OAD <br />i <br />j PEASONFORSPPINKLEflS <br />J APPIICATION ACC. BY <br />i' <br />, <br />LpTAHEA <br />nn ar coxsr. ectuei <br />NO.OF STORIES <br />FIflE SPfl11KlEFl5 REO'D <br />❑ YES ❑ NO <br />PUNS APPIIOVED BY <br />FEE <br />VACANi SIIE <br />O YES � NO <br />0¢uvuKr NoaOMLLMaI <br />eqpuv <br />BASEMENT <br />❑.VES ❑ NO <br />HEIGHT LIMITATION <br />CIfY OF EYEflETT <br />LOCALSALES <br />TAl( CODF. IS 3105 <br />CONTACT PERSON �ND PHONE NO. <br />I HEREBY CERTIFV THAT 1 HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS UF U1WS AND ORDINANCES GOVERNING THIS T'PE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEHTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS U1W 1827 RCW AND 296.200 WAC. <br />SIGN�TUflEOiCONTMCTORORAUTlqqI2EDA6ENT D�TE <br />"�.�����n..� � y- sd <br />APP TS CI BUSINESS LICENSE NO. SINESS NAME <br />uccu�uie�i <br />VENTILATION FAN <br />RANGEHOOD <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PUNCHECKNUMBER I FEE <br />FEES <br />sui�owc <br />PLUMBING <br />MECHANICAL <br />OTHE9 <br />STAtE BUILDING SUqCHAFiGE <br />S7ATE ENERGV Sl1RCHARGE <br />PUBLIC WORKS <br />TOTAL <br />S <br />a � <br />E ' <br />RECEIPT NO. <br />FEE <br />�-1 <br />� <br />I <br />� <br />� <br />� <br />i <br />i <br />i <br />i <br />_—� <br />i <br />i <br />