Laserfiche WebLink
APPLICATIO.J F�1R CONSTRUCT►JN PERMIT ��"�:'t <br />TO BE COMPLETED 1N INK—PLEASE PRINT � <br />tba Evnrgreen <br />C1VOF <br />everett , <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLI710N <br />COMBINATION <br />HEATING SYSTEM: [�(GAS ❑ ELECTRIC ❑ <br />BUILD!NG <br />GTY <br />a� <br />PHONE <br />SIGN <br />�i�CNItEGTOBO"SIGNER h�m�auu�¢�� ""' <br />GEHLRALLONTRAGtOR MNLAD�PE55 CITY ZiP PH01:[ LiCENS[• <br />MF.GNANIGALGONiRACTOR IAPILA�DRE55 QTV 'P PHCNE I.ICENSE• <br />l�1ot�-��u�� I IO Vu_ -�I_�` Ve�Pii-f- �i���I ��GS��I I��v-Nnw�LC�3R�. <br />PLUJMOR,l1�GLONTRAQGR IAAIL��DHE55 <br />GTY ZIP PHONE LICENSE� <br />`Mi' I`J _— <br />CLASS Of WORK - <br />�JJEW '. �: ADDITION ��. ' ALTERATION '. ��. REPAIR �.��� DEMOLITION I.l WOODSTOVE/FRPL INSERT �..-i BUILDING RELOCATION <br />,j�/�f�� CNON'ITA�CIT' PEFS�OIN �N/D P�H2OINE NU��p /-�{� <br />COHiRPGTPRICEOF WOM I � (Q`(, (�.� Iv� �� hUl `�S� iTLC� � � `1 � <br />PliOPO5E0U5EOFBUIL0ING ' <br />�1L'1.��' �'y'—i�- `l �'L � i�GS 1( <br />LEGAI� zC PiICNOFPROPCRTYISH 4NOELOWORAt <br />LOT BLIX:x OF _ <br />� � �� 00 - , � <br />���- <br />P��ypq� u��cc(�c,n� 'v� <br />CG71 <br />iINK 8 <br />IER <br />TRAY <br />iyE�iR:1� <br />`(i}fa\� <br />FOR OFFICE USE ONLY: <br />FRONTSETUACK REAFSET�ACK <br />use zone � �o* nn�n <br />iYPE0FL01115AllOWAOLE iYFE0FC9115t.ACIDA� <br />SREOF�LOQ NO.OFSi0RiE5 <br />OCCUPPNGY LOAD FIRE SPRNKLERS R[O'0 <br />INT4HEOY I PlANS�PPROVEDOY <br />FEE <br />SIDE SETpACK <br />I HEREBWCERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPUCATION AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL . <br />PflOVISIONS OF LAWS AND JRDINANCES GOVERNING THIS TVPE OF <br />WORK WIIL BE COMPIETED WITH WHETHER SPEGIFIED HEREIN OR �. <br />NOT. THE GRANTING OF A PERMIT DOCS NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY �� <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � <br />PERFORMANCE Of CONSTRUCTION. THAT I AM AUTHORIZED BY THE � <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH ', <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE ��. <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. � <br />SIGNATIIR[ OF CONTflAGIDF OR AUTHOHRED AGENi DATE �a -� y-�� <br />� �I/1 l�l'Cr� 11-t�1Y\ aJ��-��� i <br />pFPLIG�NTS CITV 9USINE55 LICENSE NO. ANO �USINE55 NAME <br />OF E�UIPMENT _ � FEE <br />FOFiCE� AIR 5`.'STEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />CHECKNUMPER FEE PECEIPTNO. <br />3 S/ 3 �-- <br />DUILDING <br />OiL'.ICRNLY 110 O(VA(ll',!:G�V�.I$ <br />°N0°' PLUMBING <br />BASEAIENT MECHANICAL <br />HEIGNTLIMIi�T10N �1�DITIONAIPLANCHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBIIC WORKS <br />LOCALSALES <br />TAX COOE IS 3105 TOTAL <br />OU ' <br />�-� wxxi,::. <br />