Laserfiche WebLink
y � H <br />tl �yyy <br />C M <br />f] � H(� <br />p G7 O <br />'C y I'��L-''i'' <br />� H tl <br />O N p <br />� � (1 <br />r y � <br />N '3 <br />N <br />O tA <br />� � r <br />O � <br />APPLICATION FOR CONSTRUCT�uN PERMIT � <br />TO �E COMPLETED IN BLACK INK—PLEASE PRINT <br />I._I�IEAiING SYSTEM: � GAS I] ELECTPIC I] _ l <br />6UILDING D[PARTMENT — <br />259-f3810 <br />i DEMOLITION i i COMBIMATION BUILDING �I I MECHANICAI I i PLUMBING I I SIGN <br />a�yi��� n�nnnouness cnv zm ruonc <br />�V'Y"JZETi Si�G /1u7i�UP�� �Cd�. PJ�Gd2 S! ���/�L ��ZU/ o•�J� l�ZZZ <br />�p��,q�i RI�ILADI1fif.55 CIIY IIP f9�ON[ <br />MG��iLCiGRDE5iG1![❑ M�ilApOfifSS CIiY 2iP 19�OtlE <br />_p,%r:en��✓ �,n�,1���n �z eurrr �v �v�z'zr� wa 9�zo� �sF3r�/ <br />f.U1EMLcoNtMdon hlNtnoon[ss clrv Zlr rnoN[ StniEUtENSE� <br />Jo le. �o ••� <br />rarcun����n�cor+rnncron n�nanooness arr zm rnou� SiAtELICENSE� <br />�rwr.mniccor+mncron n�ni�nuonr.5s cnr zm ruone s�n�cucer�se. <br />C14550F \YOf1N <br />i I NEW I' AD�ITION I I ALTERATION � REPAIR I I OEMOLITION !� WOODSTOVE/f-RPLINSERT I I BUILDINGRCLOCATION <br />comnerr�nsor+n/� >rnoe�e�N�/o <br />r.�rirnncrrniceovwonK —f o�l, Ur'la, DOD %pryt,_�p(�$SPTT a5�' 3��i'� <br />/ / 9� Nou=�d4 U� <br />Pr10ro5[o usE oF 0 WlolrlG <br />Ll7CJ /A�COirt �p�j(15� <br />iecni oescmm�oN or rnovenn isav+N <br />ior o�ocK <br />oF <br />PfiQl[Gl AUOf1E55 <br />�.��.�-ar-a�-,�� � <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH B�SIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />�ISIiWASfiER <br />LAUNDRYTR�Y <br />CLOTH[S WASHER <br />U'IINAL <br />LF7INKING FOUNTAIN <br />fLOOR Uf1AIN <br />�ACKFLOW PREVENTERS <br />ROO� DRAINS—R�INL[AD[R <br />FOR OFFICE USE ONLY: <br />rnor+rseroncK nEnn. <br />i'"VI � % i <br />usE <br />IYP[OfCON15 P:1041�91[ <br />nw Gb1h�C^� <br />S V E OF OLOG. <br />r� G1�A�L� <br />^O,G�CUPAN`CAY,�LOIA/D <br />IW C/�"INIV(:'�� <br />❑E�SON fO05Pf1iNNL[f15 <br />P1�4HE OY ��/ <br />SU� TO <br />PBRMIT <br />L� <br />NO OP SiONES <br />I <br />FIRE SPfiNNLE1IS REa <br />�� <br />rtne+s nrrnovw nr <br />I HEREBV CERTIf-Y iHAT I HAVE READ AND E%AMINED THIS <br />APPLICATION ANO KNOW 7FIC- SAME 10 BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLEiED WITH WHETHER SPECIFIED NEREIN OR <br />NOT. THE GRANTING Of- A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OP CONSiRUCTION. THAi I AM AUTHORRED BY 7HE <br />OWNER OF THIS PROPEF�TY TO PERFORM THE WORK FOR WHICH <br />11PPLICATION IS MADE AND I COMf'LY WITH Tl1E ST�TE <br />CON A(, ORS LAW 27 RCW AND 296.200 WAC. <br />� w c«vLK% ! /- 3 • i? <br />cr.runn�r ner[ <br />TYPE OF EOUIPM <br />NC—A/HNDLG UNITS—Ii.P. <br />FORCED AIR SYSTEhiS—�. <br />UNI7 HFAIEf7S—OSU. M <br />CLO7HES �RYERS <br />VENTILATION fAN <br />RANGGHOOD <br />WATER HEATGfi <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMI <br />FlFlEPLACEINSE-RT <br />HUT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />$ <br />siorseioncrc rinNcnecKnuMuen Fee <br />� -1 <br />vncnr�t sne FEES <br />OUILOING <br />a:wr�xr�r Gn m rvMLL�x4VMi�5 ----- <br />r,nnm —� pLU1d01WG <br />� <br />OASEMENI IAECHANIC�L <br />ti'G <br />11[IGIRIIAIII�t10N �O�ITIONALPUNCHflCK <br />SPRINNLEfI <br />STATE OUILf1ING SUfiCHnf1GE <br />CITY OF EVERETT ruouc wonKs <br />�ocn�sn�es <br />Tnx cooe is a�as TOTa� <br />E.A. <br />TOT�L <br />�11T <br />1L FEE <br />necemrNo <br />FEE _ <br />� <br />