Laserfiche WebLink
��a[�� <br />� N � <br />'�" H <br />9 H tn <br />H�� <br />� H� <br />oxo <br />�H� <br />fA H <br />:�i � LT7 <br />HC <br />OH <br />��g <br />(,] V n <br />zH�y <br />�HH <br />8 `� <br />H <br />n d � <br />� � CT] <br />H O [yi� <br />� �s.._! <br />�,. � <br />r � <br />+s �r <br />APPLICA� �ON FAR COt�lSTRU�.TION <br />P�EFtMIT <br />rne Ecerpreen <br />C:TY OF <br />everet�t <br />BUILDING D�PARTMENT <br />r�vrru <br />� <br />259-08t0 TO BE C'JMPLE i ED IN INK — PLEASE PRINT <br />OCM[R I.�a�LnoL`n[5i OI� bP P.IorvE <br />�floNJ� f? t)l�nl ��-ic� ��G+�LAP�� �;�11�� %�03 �5� �8��' - <br />i[NANT LIqLADDR[5$ GIiY ZIP PIIOYI <br />�-n2� - - <br />Ai1C111itCTOR0E5�GNEN M1�/•IIPDORE55 CRV Z�P FNONE <br />L <br />G[NEFFLCONiRPCTOP Ml.RPDORE55 Clt\ 21P PNONE LICENSf:• <br />!/ <br />InrCM��M�CALCONiR�CTOR MRILADDFE55 GITY Zi� FMONE LILENSC• <br />v <br />P1.t149WaLOt1iPFCTOri h1NILA0DPE55 LITY ZiP PMONE LICENSE• <br />rr <br />❑ NEW tiq ADDITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br />CONTF4CT PAICE OF WORK <br />LCi_— BLOCN OF <br />�' �7� ^ <br />PLUMBING <br />NO. � <br />,2 WATERCL <br />/ BATHTUB <br />IAVATORY <br />SHOWER <br />KITCH EN ; <br />DISNWASI <br />LAUNDFV <br />CLOTHES <br />URINAL <br />ORINKINC <br />FLOOR DI <br />FI%TURE OR ITEM <br />DISP. <br />DRAINS— <br />:FRVICE — <br />pLLOWABLF1NLiU�L <br />IHEREBYCERTIFYTNATIHAVEQEADANDE%AMWEDTHISAPPUCATIONAND <br />KNOW'HE SAME TO BE TRUE AND CORRECT. All PROVISIONS OF LAWS AND <br />ORDINANCES GOVERN��G THIS TVPE OF WORK WILL BE COMPLEIED W�TH <br />WHETHER SPECIFIEDHEREIN OR NOT.THF GRANTINGOFAPERMITDO[5 NOT <br />PRESUh1E TO GNE AUTHORINTO VIOLA1c OR CANCEL THE PFOVISIONS OF <br />AN V OTH EF STATE OR LOC4L LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV �HE OWNER OF <br />THIS PROPERTYTO PERFORh1 TNE WORK FOP WMICH APPLICATION IS M11ADE <br />AND I COMPLV WITH THE S7ATE CONTRACTORS LAV.' 1827 RCN' AND <br />296.200 WAC. <br />sic��n*un[orco�urancronnr:auu�on¢eoacer+t oatc <br />X���—� % � �� - -��— <br />1- �' <br />AP LICANiSC�iV0U5ME5iUC(YS6NORNDBUSINESSNAI,1[ <br />MECMANICAI <br />FEE NO. TYPEOFEOUIPMENT <br />NC— WHNDLG UNITS— HP <br />FORCED AIR SVST[M11S— B.T.U. M EA <br />UNITHEATERS—�LU M <br />CIOTHES �RYERS <br />VENTILAiION FAN <br />SUBTOTAL 5 <br />PERMIT S <br />TOTALFEE S <br />REd(iSEiBACK SIDESEiOACN <br />LOiAP[A VACANfSR[ <br />l YES :1 NO <br />OGGUPANCVaROUP NOOFpWELLII <br />NO OF Si0PiE5 &SMt. OCC LOAO <br />❑V <br />❑N <br />NEIGHT LIMIIAI <br />❑ YES ❑ NO <br />STOVE <br />METAL <br />FIREPL <br />GAS PIPING <br />EXHAUSTFI <br />FEES <br />BUILDING <br />PLUMBING <br />FEE <br />SUBTOTAL 5 � <br />PEFiMIT 5 <br />TOTALFEE 5 <br />FEE PECEIVTNO. <br />YALUATION FEE <br />MECHANICAL <br />OTMER <br />STATE BUILOING SURCHARGE <br />STATE ENERGV SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />a <br />