Laserfiche WebLink
,;, <br /> ,,.... :. <br /> '� APPLIC��'ION FOR CONSTRI.::TiON <br /> " PERMIT � <br /> Ihe Everyreen cvcrelt <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 TO 8E COMPLETED IN INK— PLEASE PRINT <br /> ,� Mu�noor+ess cnr zm PIIONL <br /> ��/yt�s fi�//�f,v i.1/�_��.��J ��F,eerr 9�3a/ :�I�B- 3 ��/ G�� <br /> 7ENANT M�IL�OORESS CIIY Z�� P����E O�' WON\ <br /> 355-Z �i- <br /> ARCNREGTOROE9IGNER MML�DORE55 CITY ZIP PNONE <br /> OE � GONTN�CION MAR�DDRESS CIIY ZIP PMONE LICENSE• <br /> ��o,u �,�.rT �y�� �tb�ia�dy,� �'�ear.-r 9�afly �756a O/Sn,vP�/�//KZ <br /> MECH�NIC/�LCANTH�CION M�IL�DDRE55 CILY ZP V11ON 4CENSE <br /> PLUMBIIj ONTMCTOR M�II�DORE54 CIIY ZIP PIIONE IILEN9E• <br /> �I�2f/.vn/ �on6?i�r.� �vEitcrr ��i{o� :��'�-�F3Z �//,eH.00.?63r� <br /> �ugypFNVRK � <br /> ❑ NEW ❑ ADDITION �I RLIERATION I.� REPAIR ❑ DEMOLITION ❑ WOOOSTOVE/FRPLINSERT ❑ BUILDINORELOCATION <br /> 1ENNIT IMFROVEMENT OR INTEBIOR REMODEI ONLY CANTACT FENSON AND FMONE NO. <br /> CONIMCT%11GEOFWORUKy�ppy ��q O �DIJ �� <br /> � ���/�/v/�C'�/�y� /�Clr1 �W��S 1/ NSf�f// 14�T L'i <br /> o:[s •� P!«�G �r,� ��rr.� i,✓ a,fN <br /> pppppsE�D.�6EOiBUIlDINO �j� HEREBVCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICAT�ONAND <br /> /2]o.eC���� QJ r7 KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> ��� � ORDIN�NC[S GOVERNING THIS T'PE OF WORK WILL BE COMPLETED WITH <br /> IEMLDE9CRIPTIONOFPPOVERtt�9HOWNB L A�n�CMFOURCOP WHETHERSPEC�FIEDHEREINOHNOTTHEGRANTINGOFAPERMITDOESNOT <br /> PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> tpt BtocK or ANYOTHERSTATEORIOCAILAWREGULATINOCONSTRUCTIUNOflTHEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHOR12ED BY THE OWNER OF <br /> THIS PROPERTV TO PERfORM THE WORK FOR WHICH APPIICATION IS MADE <br /> AND t COMPLY_WITH 7HE STATE CONTRACTORS LAW 1827 RCW ANO <br /> 296200 WAG --�— ��Q/a� <br /> S�GNAfUREO GOMMCiORORAUfNpR12E0�GENI O�iE 0 0 — <br /> X � ✓ �e� <br /> RqJEGiMDRE99 /� APPLIC SCIlYBU51NE5 IGENSENO.�NDBUSWESSNAME <br /> `', �.?/� Fv/LANc/ Gd£ JE22 t� W a• <br /> ;! pLUMBINa . MECHANICAI <br /> - �NO. TYPE CF FI%7URE OR ITEM FEE � � N0. ` 7YPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIlET) A/C—A/HN�LG UNITS—H.P. <br /> , �TMNB FORCED AIR SVSTEMS—&T.U. M EA <br /> UVATORV�VVASH BASIM UNIT HEATERS—&T.U. M <br /> i , 3H0�R CLOTHES DRVEAS <br /> � KITCHEN 91NK8 DISP. VENTILATION FAN <br /> � '� DISHWA9HER RANGEHOOD <br /> ' ��� 1.AUNDRY TMY WATER HEATER <br /> � � CLQTHES WASHER WOOD STOVE <br /> � ' URINAL METALFIREPLACE6CHIMNEY <br /> � OHINKINO FOUNTAIN FIREPLACE INSERT <br /> � FLOOHDRAIN � HEATPUMP <br /> '� � BACKFLOW PREVENTERS GAS PIPING <br /> �� qpOFDRAIN9—RAINLEADERS E%HAUSTFAN <br /> � SINK(SERYICE—BAR,ETC.) <br /> i ' <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT S PERMIT E <br /> TOTAL FEE 5 TOTAL FEE E <br /> fRONT8ETd1LR FEARSEfB�CK SIOESETBI�GN PUNCH CKNUMBEB FEE _� p,G RECEIPfNO. <br /> � � � $$ �� III `3 , �� fyuO <br /> �sezo � �OT�NE� OYESTs�Ho FEES VALUATION FEE <br /> � ��Y� BWLDING � <br /> 7VPEOFCON9T. OCCUVANCYQROUP NO.OFOWf�NOUNl19 � <br /> /y�pW�BLE/ACTUAL�. 1 � � PLUMBINO 1 <br /> !V <br /> 812EOFBlOQ NO.OF9TORIE9 esut. otcto:D/� MECHANICAL <br /> NA- Y •� — — <br /> ❑ N <br /> MEI6NilIMlfAiION OTHER <br /> FIRES�RINI(LERSREOUIflED ❑vE9 No �� STATEBUILDINGSURCHARGE <� <br /> � . STATE ENERGV SURCHARGE <br /> � �ppuunoNAGGBY PUNS�GPRBY PUBLICWORKS <br /> � Zcin �j <br /> ; td:� �✓`" TOTAL Z. � �O <br /> i <br /> t <br />