Laserfiche WebLink
,� <br />fM E�+ryrNn <br />urv oF <br />everett <br />BUILD�NG DEPARTMENT <br />259-8810 <br />APPLIC�ION FOR CONSTRIi�:T10N <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />ih <br />everett <br />e <br />�R�M(fECTOR0E5qNER MML�DORE53 CIIY 2iP PMONE <br />OENEMLCAMIRAGTOR MMLIIDORE55 GIIY ZIP PNONE LILENSE• <br />��N����Tpp MAIL�DDRESS GITY 21P �NONE LILENSE• <br />0.UMMN0 MCTOR M�IL�DDRESS CILY 21P PMONE LIGENSE• <br />uwee vr m.... <br />❑ NEW ❑ ADDITION ❑ AITERl1TION ❑ REPAIR ❑ OEMOLITION _O. WUOOSTOuE/oAucuNSERi ❑ BUILDINGRELOCATION <br />Oi WJ111C <br />wr xoac o� <br />) FlIQRCT�DDRE9S ��V'/ / <br />� Y .J /�S � <br />rLUM�INO <br />■t <br />'� <br />SINK 8 D18P. <br />IIEOl1IpED O YES ❑ NO <br />FEE <br />❑Y <br />❑N <br />❑ YES .1 <br />� '..� _:.r •. _.___ <br />1 HEREBV CERTIFY THAT I HRVE READ AND E%AMINED THIS APPLIG1nON AND <br />KNOW THE SAME TO BE TAUE AND CORRECT. ALL PROVISIONS OF LAW9 AND <br />ORDINANCES 60VERNIN6 THIS TVPE OF WORK WILL BE COMPLE7ED WIiH <br />RESUME TO GIVE AUTHORITV O VIOLATE OR CANCEL THEPROVI&O 90F <br />RNY OTHER STATE OR LOCAL LAW REDUTATINO CON9IRUCTION OR TME PEFF <br />FORMRNCE OF CONSTRUCiION. TMAT I AM AUTMORIZED BV TME OWNER OF <br />TNIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION 19 MADE <br />AND I COMPLY WITH TNE STATE CONTRACTOR9 LAW 18.27 RCW AND <br />288.200 WAC. <br />4i6N1TIlREOFCONiR11GTOROPAUT110P2E0�0ENT D�iE <br />�PPLIC�N dTY USME55 GENSEN .�NOBUSINI <br />�EC CAL <br />�p, TYPE OF EOUIPMENT <br />NC — NHNDlO UNIiS — H.P. <br />FORCED AIR SVSTEMS — B.T.U. M <br />UNITHEATERS—B.T.U. M <br />CLOTHES�RYERS <br />VENTIlAT10N FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE d CHIMNEY <br />FIREPLACEINSEPT <br />HEAT PUMP <br />6A5 PIPIND <br />E%H�USTFAN <br />FEES <br />BUILD�NG <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUIIDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />� <br />