Laserfiche WebLink
.-. ^Ce�`2 GiP <br />APPLICATION FOR CONSTRtJCT10N <br />PERMIT <br />Ine Everorean <br />CITY OF everett <br />everett � <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNER MMLAOOPE55 CIIY ZIP PIIONE <br />�]1f ?auc�n�o„Jt? 19ot•I.ra} L•i�.u,l.. Avc Ye��w,. 9Avn� Csa) e)r_ narn <br />�RGHITECTORDESIONER M�II�pORE55 <br />.i�..., . A..le.u.. ,J.�..... - �1n n,...�,.. c,- # <br />"' �^ ^ LICErvSE • <br />4saoz. rs���S7r-1qr� -c�r�.T i�i� <br />Z-_ �P �` NONE UCENSE • <br />PLUM&NOCONTMGTOR M�I�ADONE55 �itY 21P PIIONF. LILENSE• <br />m�,"+e,� ��ew p��• L� ,- �13�Ic- SZ"� ST �',,,� 98 n3 2SA-9�Sb�lar,,{ve COy <br />G44430FN'O K <br />❑•NEW �❑,cADG^TION^^❑ ALTEflATION ❑ REPAIR ❑ DEMOUTION ❑ WOODSTOVE/FRPLINSERT . ❑ BUILDINORELOCATION <br />CONTMCTpqICE <br />LOT � _ BLOGK OF <br />encaJ <br />l(c��L 1-�� <br />PLUMBIN6 � <br />VO. TYPE OF <br />WATER CLOSET (Ti <br />� BATHTUB <br />LAVATORV(WASHI <br />SHOWER <br />I KITCHEN SINKB D <br />lACKFLOW PREVENTEiiS <br />IOOF DRAINS — RAINLEADERS <br />iINK (SERVICE — BAR, ETC.1 <br />SUBTOTAL 5 <br />PERMIT E <br />TOTAL FEE S <br />�K / PE�RSEt9�Glt SIpESEifi4CK <br />C �1 <br />' iounee 1 ve r�rsr� <br />�'� % 000 f� �s ❑ No <br />neouineo <br />-3 <br />v <br />� v"" <br />i <br />I HEfiEBV CERTIFY THAT I HAVE READ AND EXAMINE� THIS APPLICA�ION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVEFNINCa 7H�S 7VPE OF WORK WILL BE COMPLETEO WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTINC OFA PEHMIT DOES NOT <br />PRESUME TO GIVE AUTHOR�IY TO VIOLATE OR CANCeL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PER- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WOHK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WIiH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAG <br />SIGNRIUREOFCONTRAGTOf10FAUTNORIZEO�GENT D�TE <br />X�p �,�$,�9 <br />RPPLIC�NiSGIiYBU51NE 5 I ENSG ~NDBUSINESSN�ME <br />MECHAN:CAL <br />NO. TYPE <br />" AIC—A/HNDLGI <br />" FORCEDAIRSYS' <br />— UNITHEATERS— <br />' CLOTHES ORYER <br />'— VENTILATION FAN <br />� RANGEHOOD <br />WATEfl HEATER <br />� WOODSTOVE <br />METAL FIREPIACI <br />FIREPLACEINSEF <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />� <br />H.P. <br />BT.U. M EA <br />M <br />8 CHIMN[Y <br />PERMIT <br />n;nc nn�'n m �F!_7 ^ <br />�'�. r-� � � /�� •����.�-( <br />FEES VALUATION <br />BUILDING 1�1 �?L, - <br />f'LUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />