Laserfiche WebLink
(''. <br />�'i :',.1r1 ' <br />�;'PPLICATIC�N FOl�' <br />'".E".'°,"° CO N ST f� U CT 1 O N <br />CITY OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETF_D IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL <br />..,.�..�., i _ , raan enonFss titt ':.�P <br />O PLUM9ING <br />PnOrvE <br />tverett <br />e <br />❑ SIGN <br />GEUEdnLGONiRACiOR MAILAODRE55 Clrv ZIP v1�pNE LICENSE• <br />u[Pneewfsilf.ONiP/.f.iON . . . . MLILApORE55 . � / ��N , ZIP PIIONE IICENSE• <br />Cltt <br />PIIOHE <br />NEW ❑ ADOiTION ❑ ALTERA710N ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVElFRPL.INSERT ❑ BUIL�ING RELOCA710N <br />j�QN OF WORHILOSi Of IAAtER'�LS ClUSIABORI <br />USE OF <br />L[GFL O�SCNIViION OF PN <br />�m—e�oc�— <br />�LUMBING <br />NO. TYPE OF FIXTL <br />WATER ClOSET �TCILET� <br />BATHTUB <br />LAVATORV�WASH 8/SIN) <br />KITCMEN SINK d �157. <br />❑ISHWASMER <br />LAUN�RYTRAY <br />VLOTHESWASHER <br />UFINAL <br />ORINKING FOUNTAIN <br />`IOORORAw � <br />LONE <br />i OF CON! <br />cre�oc <br />� DRAINS — RAINIEA�ERS <br />�SERVICE — BAR. ETC.) <br />SUBTOTAI <br />PERMIT <br />TOTnL FEE <br />LOi <br />OCCUPANCVGROl1P <br />N4.OF SiON1E5 <br />' I tiEREBY CEf7TIFY THAT I HAVE READ AND EXAMINED ThiIS AP- <br />PLICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL <br />AIIACMLOURCOPIE51 PROVISIONSOFLAWSANDORDINANCESGO\�EP.D!�NGTHISTYPE <br />OF WORK WILI BE COMPLETED WITH WHETHE� SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOE;I NOT f'RESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRGVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. . <br />$IGNATJ,{96f,L CONTRACTGR OP AU7NOq ��n AGENT pqTE <br />FEE <br />WCANi SITE <br />❑YES ONO <br />NO.OF pWELIING UNITS <br />OCG LOAO <br />MECHANICAL <br />A/C — A/HNOLG Uf�ITS — H.P. �- <br />HEFflIGERATION UNITS — M.P. EA. <br />BOIIERS — O.T.0 /H.P. <br />GAS FIRED A.C. UNITS — B.T.U. <br />FORCE� AIR SYSTEMS — B.T.U. M EA. <br />WAILHEATERS—B.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTMESbRYEFS <br />VENTILATION FAN <br />RANGENOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIPEPLACE d CNIMNEV <br />FIPEPIACE INSERT <br />MEAT PUMP <br />GAS PIPING <br />F%HAUSTFAN <br />SUB'fOTAL <br />PEflMiT <br />P�nN CHECN NUMBER <br />FEES <br />BUIIDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />Lli.fi� BUII.DING SURCHARG <br />STATEENERGYSUFCHARGE <br />PUBLIC WORKS <br />TOTAi <br />FEE <br />$ <br />FEE <br />RECEIPT NO. <br />PROPERN OW".ERS ARE RESPONSIBLE FOR DETERMINING ALL <br />PROFERTY L INE LOCA7IJNS AND RELATED EASEMENTS. <br />