Laserfiche WebLink
APPLICATIC'1 FOR CONSTRUCT"�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—ALEASE PRINT <br />BUILDING DEPARTMENT I HEATING SYSTEM: p GAS I�LECTRI� C] _ _ j <br />259-8810 <br />❑ DEMOLITION �'COM&NA710N ❑ BUILDING O MECHANICAL ❑ PLUMBING ❑ SKiN <br />ONR/ER M�lAOdESS LITV ZIP PIIONE <br />L-ANRL NCE N. ANd d E �r7'E c. N� �/�� 2 �'i � hrN�+� �f• 9 8w i a..; �-� ysa <br />iEwwi ewu�noness tin ziv vNone <br />' 11RGIrtECTORDE5IGNER <br />� <br />NALBACR CONS <br />Ave. riu�oor�a�u ni� <br />198201 EVERETT, <br />\IAIL INOREBS <br />CITV M PNONE <br />ZIP <br />ZIP <br />NA�llnc L <br />STATE LICE119E • <br />PIpNE ST�TE LICENSE � <br />pWyA�q�qNipACtpq Y/UL11pppESS CIT' 21P PHONE S1�TELICENSE/ <br />D�9� b�Ar.Es 3'I « KR-oF,f.e Cz'CR,EfT wi+ y ifw� �..; L398o — <br />COIAMCT►RICE OF MIORK , <br />usE oF euaoMca <br />� �C 3 L �� �.i_3__ aF ��." <br />►MCEL TA7I I.D p <br />53�-�s3-03i- <br />CONli1111CT10N LMN IEMDER. AOOIIE88. TELEMIONE MlMBER <br />KITCMEN <br />ORAIN <br />.OW PRE� ENTERS <br />Fon o�ce use a+�r: <br />FnoHre�a�ac �! <br />��� G <br />�� <br />FIRE SPRINKLERS RE09 <br />FIRE 11lARM REO9 <br />N� <br />PlANS AP]RQVED Bv <br />J� * <br />o�.� a /�/rs� <br />CONTACT PERSON MIO P110NE NO. <br />LSL-�iYSO <br />I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT. ALL <br />PROVISIONS OF UWS AND ORDINANCES GOVERNMKi THIS ?YPE OF <br />corrts�y��� NIORK WILL BE COMPLETED WITH WHETHER SPECIFIED f1EREIN OR <br />� 1 vv�pp, NOT. THE (iRANTING OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEI TME PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATIN6 CANSTRUCTION di THE <br />PERFORMANCE OF CANSTRUCTION. THAT I AM AUTHOq1�D BV THE <br />OWNER OF THIS PROPFRTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION �S MADE AND I COMPLV WITH THE STATE <br />� CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />: �a,►.�... 7'V %� %� � �s <br />gpµ� MR <br />r <br />VACANT SRE <br />❑ YES ❑ N� <br />arw�xcr �ro.aowewxeuxirs <br />❑ YES ❑ NO <br />TAX CODE IS 9105 <br />UNR HEATERS—B.T.U. M <br />C�OTMES DRVERS <br />VENTILATION FAN <br />MNOE HOOD <br />VWUER HEATER <br />WOOD S1'OVE <br />METAL FIREPLACE (W000 <br />flHEPIACE INSERT <br />HEATPUMP <br />GAS PIPIN(i <br />El(MAUST FAN <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />i�s. �v � � 9�� <br />BUILDIN6 Z�f (ps(p �S� � <br />� <br />PLUMBING � i <br />MECHANICAL �� <br />i <br />i <br />ADD�TIONAL PUN CHECK i <br />i <br />orHeR ; <br />STATE BUILDINO SURCHIIRGE � <br />PUBLIC WORKS �! <br />ror�� � <br />