Laserfiche WebLink
\:,'•��' �1� <br />APPLIC:dT10N �OR CONSTRIy�::T10N <br />PERMIT <br />Ihe Eveipreen <br />CITV OF everell <br />ev�rett e <br />BUILDING DEPARTMENT <br />259•BB10 TO BE COMPLETED IN INK— PLEASE PRINT <br />I�WNEP /MFILPDOfiE55 / CIlY ZIP PHONE <br />:�l�.vGv i✓e%,o»�w.. 7` //1:�5'/li�,y.���.r S� �"veya���s�7oY _7,.77- /vLC <br />TEN�NT —� MFILRDDPES$ GIfY ZIP Vb� '�E <br />- !/ir / � . _ / / �� .. _, <br />,� <br />MECNANiC�LG@RRACION MRILA�DRE55 CI1Y 2iP PMONE LIGENSE• <br />PLUMBINOCON1MClOfl MRILtDORF55 CIiY ZIP PNONE IICENSE� <br />p- NEW ❑ AOD!TION ❑ AL?ERATION ❑ REPAIfi ❑ DEMOLITION ❑ WOODSTOVE{FRPL INSEFT ❑ NUILDING RELOCATION <br />CONiMCT PFICE OF �!OBK <br />DESCRIBE WOHN �ND SOU� <br />7s0�1�r1 <br />l0T BLOCN OF <br />�Ov S <br />PLUMNINO <br />OF FIxTURE OH ITEM I FEE <br />DFINKINCa FOI <br />FLOOR DRAIN <br />ROOF ORAINS— <br />SINKISERVICE— <br />= hl I 3-'L <br />�NQOFS10RiES �M <br />I � N <br />SREOUIREO ❑ VES f�f10 <br />—� <br />:or ruNserrp.er <br />� �—� . <br />I H'REBY CERTIFYTHAT I HAVE READ AND EAAMINED TH�S APPIICATION AND <br />KNOWTHESAMETOBETRUEAN�CORRECLALLPROVISIONSOFLAWSAND <br />ORDINANCES GOVERNING THIS TYPE O� NORK WILL BE COMPLETED WITH <br />W HEiHER SPECIFIED HEREIN OR NOT. THE GRHNTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHQflITV 70 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LO�AL LAW REGULATING CUNSTRUCTION OF THE PFR• <br />PORMANCE OF CONSTRUC710N. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WO(iK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH 7HE STA7E CONTRACTORS LAW 18.27 RCW AND <br />298.2LW WAC. <br />SIGNRiUPEOFCONiPACtOROR�UtHOPIZE0AGE4T DALE <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />A/C—A/HNDLG UNI7S— H.P. <br />FOFiCED A�R SYSTEMS — B.T.U. M EA <br />UNIT HEATERS— B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEIIOOD <br />14A7ER HEATER <br />❑ NO <br />IWELLINOUNIIS BUILDINQ <br />-- PLUMBING <br />4D <br />MECHANICAL <br />LIMIiQ10N OTHER <br />- STATE BUIIDING SURCHARGE <br />SiATE F.�vERGY SURCHARGE <br />YJbLIC WORHS <br />TOTAL <br />� <br />— /• <br />