Laserfiche WebLink
APPLICATIQ''Y FOR CONSTRUCY�JN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRI�YT <br />BUILDING DEPARTMENT HEATING SYS7EM: GAS I] ELECTRIC ❑ <br />259•8810 <br />CJ DEMOLITION I I COMBINATION �BUILDING I I MECHANICAL f_I PLUMBING I_ 1 SIGN <br />OWNFR M�ILAOpPESS Citt 21P o�{ONE <br />�v�-rr hOu.L'/G �A[JTiJo['s*>' i4o� G�r.a,e t✓�.e�,r w� �'�oi ac� �va��'u� <br />TENANT M�IlA0DRE55 CITY 21P PHONE <br />�RGHITEGiORDE5IGNEP MAILAODRESS CITY ZIP PHONE <br />DYkEJ�Ll� AR�'�/lrevS ��oz fiE,w�rr ^'� �ve,e.=T �uR �'0ao/ ao� a5t 3��/ <br />GENEMLCONTHACTON MAILADORE55 CITY ZIP PNONE STQELICENSE/ <br />ic' 3 <br />MECH�NICQLdJiR�CTOR M�ILADORE55 CITY 21P PNONE STREUCENSEt ` <br />- PIUMBINGCONTR�CTOR M�ILAODHE59 CITY 21P PNONE STATELICENSEI <br />CUSS OF WORA <br />I I NEW f� I ADDI'.ION �LTERATION �• REPAIR I. I DEMOLITION I I WWDSTOVbFRPL INSERT I J BULDING HELOCATION <br />.�.��n �•+�/� �t�n GONTACTPEPSONAN NONENO /'� �j�- /�/J��� �� <br />� CONTRICTPHICEOFWOPK ����V ` ' l�wr vW � �b{'N/ �SSC� F/�MN�� /YF-�-K�%pti/ <br />� DESCRItlF WURK AND SOU�RE F09i� E INVOLVE�—� <br />ior <br />e�ocK o= <br />8 <br />CLOTHES WASHER <br />FOR OFFlCE USE ONI_Y: <br />FHONTSET&1GN REMSETBACN <br />lYPEO�CONTSAIOWABIE � TYPEOfCONSLACNRI <br />OGGUPMC'LO�D I. I FIRESPRNKLEHSREO'D <br />ir=i�_.s f,,z <br />8Y PLANSAPP JVEDBY <br />7�Is1�JL JNI <br />SIDESETB�CK <br />V�GNlT SITE <br />a5�-3�U� <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PFtOVI510NS OF LAWS AND OFOINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTH�RIZED BY THE <br />OWNER OF S P PERTY TO PERFORM THE WORK FOH WHICH <br />APPLICA ON IS AD�AND I COMPLY WITH THE STATE <br />CONTR TORS LA 1827 W AND 2962CJ WAC. <br />� <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />WOOD STOVE <br />MiTAL FIREPLACE 8 CHIMNEY <br />a <br />PUNCHEGKNUMBEH FEE flECEIPTNO. <br />?�aa6 — �a � �r <br />BUILDINO <br />nro.wcr wawrtwrwams <br />'a�° � PLUMBING <br />SEMENT MECHANICAL <br />!iGHT uMITATION ADGITIONAL PLAN CHECK <br />SPHINKLEH <br />STATE BUILDING SURCHRRGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TA)I CODE IS 3105 ��� <br />i <br />� <br />