Laserfiche WebLink
���] <br />H <br />9H(�"i� <br />y <br />�C C] <br />H �I <br />� H � <br />fA H <br />[�1 O � <br />H t7 <br />H^�g <br />y, V � <br />t�y� <br />HH <br />� <br />gey <br />� � i=i <br />Z H fn <br />HO[n <br />'`� w <br />�' <br />�►PPLICAi1G�� FOR COt�lSTRUCT�t�i PEReV11T ��`''�" <br />�neEw�prcen TO BE COMPLETED IN INK—PLEASE PRINT � <br />CITY OF <br />everett HEATING SYSTEM: f] GAS U ELECTRIC ❑ — <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION � � CONfBINATION BUILDING '' MECHANICAL '_ i PLUMBING SIGN <br />OWNEH IAAILP�DRESS �..- CITV�S ZiP PNONE z—£� ,ZyY <br />�� %fix�/,¢.a l/SvV /�1E,�iDiArAUE S. c-vE�c--T �y�zo� 3ss-6�o7 <br />MFI�P�DRE55 CITY ZIP PHONE �) <br />T[NANT � YCT% � �IUF ����_OSI� <br />� CfiG�,t%�j' C��c �sP2E�s0 fD- G�7 �'-,x�nrr,�cc w�Y #N E� <br />naruircciOR�E5IGNER IAAILA�DPESS CiTV ZIP PHONE <br />CITV ZIP PHONE UCENSE n <br />✓GENERALCONTRACTOfl MAILADOflESS <br />^ CITV ZIP PHONE LIGENSE x <br />MECMANICALCONTiiACTOR MAILA��RE55 <br />PWI.IBINGGONTRACi0�1 IAARA�OFE% CIiY ZIP PHONE LICENSEe <br />CLASS OF WORY. _ <br />'�-. NEN �-: ADDITION (-'� ALTERATION ''� REPAIR !.; DEMOLITION L i WOODSTOVE/FRPL INSERT ❑ BUILOING RELOCATION <br />� ` I GONTAGT PERSON AND PHONE t10. <br />�. _ _ � ��� <br />�CON f R�CT PRICE Of WORK <br />DESCFIBE WOFK pND SOUA <br />� <br />�or eiccn <br />iNVOlYEO <br />I HEREBY CERTIFY THAT I HAVE READ AND �XAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORP.ECT. ALL <br />OEIUW OFATTACH FOIIRCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br />o= NOT. THE GRANTING C'F A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORIT'! TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEP. STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8V THE <br />OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATlON IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br />SIGNATUREOFGONTRFGTOFORAUiHGRIZEDAGENT OATE <br />X �/�'�J" y— (Z- Z%-�l� <br />� .� 1 I APPLICPNTSCITVBUSINESSLIGENSENO.ANOBUS�NESSNAME <br />TYPE OF FIxTURE OR <br />WATBR CLOSET (TOILET) <br />BATHTUB <br />L�'�ATORY (WASH BASIN)_ <br />SHOh`R <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRI!JKING FOUNTAIN <br />FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK R[RRSETBI,CK <br />� �577�1C's <br />IJSEZONE LOTAPEA <br />SIZE OF BLOG. <br />OGCUPANCYLOA� <br />flEA50N FOR SPPINNLERS <br />Mi, KE BY <br />FIRE SPRNKLERS <br />PLANS <br />S <br />ED AIR S`.'STEMS—B.T.U. M E.A. <br />iEATERS—B.T.U. M <br />1ES DRYERS <br />LATION FAN <br />EHOOD <br />R HEATER <br />)STOVE <br />L FIREPLACE 8 CHIMNEY <br />'LACE INSERT <br />PUMP <br />�AN � — <br />PIANCHEGKNUMtleM I rc� �'�� <br />VA�RNT SITE reeo <br />A� O BUIl01NG <br />OCCUiANCY M1J 01pWEllINGlI1:lI5 <br />taow � pLUMBING <br />DASEMENT MECHANICAL <br />HEiGHT LIMr'AiloN ADDITIONAL PLAN CHECK <br />OTHER <br />STATE Bl11LDING SURCHARGE <br />CITY OF EVEHETT PUBLIC WORKS <br />LOCAL SALES <br />TAX COOEIS 3105 TOTAL <br />$ <br />i <br />a <br />�� <br />� <br />