Laserfiche WebLink
��� <br />D � x <br />Q hi <br />> H f/� <br />H�� <br />�pH7�p7 <br />'+tl N il <br />Hy <br />YR <br />O H d <br />��g <br />n. �c,y� <br />C"yZ <br />Hy <br />8y <br />n�N <br />�O� <br />APPLIGATIO",V FOR CONSTRUC� �N PERMIT �'��«'� <br />TO BE COMPLETED IN INK—PLEASE PRIN f � <br />tne Evergreen <br />LITV OF <br />everett HEATING SYSTEM: S U ELECTRIC ❑ � <br />BUILDING DEPARTMENT <br />^ 259-8810 \ l <br />DEMOLITION COMOINATION BUiLDING �IMECHANICAL PLUMBING SIGN <br />PRO�RWT OR pE51GNER <br />uAa nooeess <br />��r1— ((�0( <br />MRIL ApDPE55 <br />MRIL AD�RESS <br />�,r�._iw�r <br />CITY ZIP <br />CiiY ZIP <br />CITV^ f/1� ZI9 <br />MECMANICAICONTRAGTON V MIILR��RE55 Gnv <br />PWM�iNGCON�flALTOR I.IAILADDRESS CITV <br />CIASSOF WORK <br />NEW �. ADDITION xAi-iERATION � REPAIR <br />PNOPOSCDUSE <br />�EGRlDESCNv <br />�oT <br />�,�_-�� L.(.�� ��i � l/'LV V� <br />o�� �-- �-� <br />CROPERTY ISIIOWN BELOW OR ATIAGN FOUB fAPIE$1 <br />BIOCN _ _ OF <br />aaecr aooAtss//� � � �� <br />C,' <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET �TOILET) <br />9ATHTUB <br />LAVATORY�WASH BASIN) <br />KITGHEN SINK & OISP <br />OISHWASHEF <br />LAUNDRV TF7AV <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEFiS <br />ROOF DRAINS-9AINLEAC <br />SINK �SERVICE—BAR, ETC <br />FOR OFFICE USE ONLY: <br />JSEZONE <br />iYPE CiL0111S A1101 <br />SREOFBIDG. <br />OCCUPANCYLOID <br />REASON FOR SPPII <br />INiAkE BY <br />IOTARER <br />NO. OF STONIES <br />FIRE Sf'PNhLERS RW'D <br />P1m15 APPROV[D H� <br />��`Y(.l_J <br />FEE <br />$ <br />ZIP <br />_ �(�i� ��- 2��� <br />PHONE <br />PHONE <br />PHQN[ <br />� �_j <br />P� <br />PNONE <br />DEMOLITION WOODSTOVE/FRPL INSERT <br />I CONTACT VERSON ANO PHONE NO <br />a <br />LICENSE • <br />Bl-ILDING RELOCATION <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE � <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK POR WHICH � <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 29G200 WAC. <br />SIGNATUREOFCC4iRAGiONORRUTNOHIIE�RGENT OATE <br />.� ° ' ���� <br />" ��, , ��dCt��� <br />qPPLICPNT50TV0U51NE5 ICEN OAND�US�NESSNFiAE <br />MECHANICAL <br />J0. TYPE pF EOUIPMENT FEE <br />A/C—A�HNOLG UNITS—H.P. <br />FORCED AIF S`.'STEMS—B.T.U. M E.A. <br />UNITHEATERS—B.TU. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER II <br />WOO�STOVE <br />METAL FIREPLACE 8 CHIMNEY I <br />FIREPLACE INSERT ; I <br />� HEATPUMP �— <br />GAS PIPING I <br />EXHAUSTFAN � � � <br />NUMBEH <br />VACANT SITE FEE$ <br />BUILDING <br />WCUo4Np NO M PMLIING W' Ii5 <br />eauuo p�UMBINO <br />BaSEAIEI�i MECHANICAL <br />1�EIGMiuMITATION ADDITIONALPLANCHECK <br />OTHER <br />STA1E �UR�ING SURCHARGE <br />CITY OF EVERETT PUBLIC WOFiKS <br />LOCRL SALES <br />TAX CO�EIS 3105 TOTAL <br />SUB TOTAL S <br />PERMIT 5 <br />TO7ALFEE 5 <br />FEE RECEIPt NO <br />VALl1ATION FEE <br />� <br />� <br />� <br />