Laserfiche WebLink
5���++� <br />b7�H <br />�HN <br />� � � <br />H �1 <br />� � � <br />� <br />yx <br />o�d <br />n <br />c��o <br />t"y� <br />HH <br />g �' <br />C]CN <br />� <br />zy� <br />H O fn <br />APPLICATIG'�'f FOR CONSTRUCT�"iN PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS 'J @LECTRIC ❑ _ <br />BUILDING DEPARTMENT <br />259-8810 <br />L7 DEMOLITION ! l COMBINATION !J BUILD�NG I�ECHANICAL i: � PLUMBING L_l SIGN <br />OWNER MAll4DDRE55 N I � CITY ,{'' 21P PNONE ��l �//� <br />� ���� 1 �,� Mh �t-/1.:N�� (_'_�r' —7 1 <br />�'r-l-. .A',.�,�_z � n� <br />PHONE <br />ARCHRECiOPDC5IGNEH MAILADOPESS CITV ZIP PHONE <br />f,ENERALCONTRAGTOP MRILAODRE55 dTY 21P PHONE STAIELICENSE/ <br />ME HFNICALCONiRACTOF MRIlAODRESS 21P PHONE SiATELICENSEI <br />��- �,,c, " �i� f� �t�� z>-1�76�k`S,l�� �I�t���/t��.n��c�n��� 4�FC�C-� 77C-73/0 SHi;NN�INc)Sll;C <br />_....._...__.,.��u�� ennoow C!rty� ZiP PHONE SiATEIICENSE� <br />CONTRRGT PRICE OF WORK <br />�ns,� <br />DFSCRIBE WOPK AND SOURHE FOOTAGE INVOLVE� <br />PROPOSED USE OF BUILDING U � <br />IEGAL DESCRIPTION OF PPOPERtt �SNOWN BELOW ON ATTACH T1V0 COPIES) <br />LOT BIOCK OF <br />PARCEL TA%1 D. Nl1MBEF <br />CONSTRUCTION LO�N LE1 <br />LAVATORV�WASH tln: <br />SHOWER <br />KITCHEN SINK R DISF <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOI"HES WASHER <br />URINAL <br />DRINKING FOUtJTAIN <br />FLOOR ORAIN <br />ROOF <br />SINK 1 <br />TELEPNONE <br />FOR OFFICE USE ONLY: <br />FRONTSETBRGH REAR SETOACN <br />USE20NE LOTRREA <br />iYPEOFLON57. NOAFSiORtES <br />SIZE Of 91D0. FIRE Si'AINKLERS REO'D <br />OCCUPANCY LORD FlRE ALAFM fiEO'D <br />REASON <br />iNTAKE DY PLANS APf POVED OY <br />DAIE <br />S <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS nND ORDINANCES GOVERNINCi THIS TYPE OF <br />WORY. WILL BE COMPLETED WITIi WHETHER SPECIFIED HEREI�I OR <br />NOT. THE GRANTING OF A PEHA7IT DOE3 �OT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL U{W REGULATING CONSTRUCTION OR THE <br />PERFOfiMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PFiOPERTY TO PERFORM I�HE WORK FOR WHICH <br />APPI.ICATION IS MADE AND I COMI'LY WITH THE ST.1TE <br />CQNTP.ACjORS LAW 18.27 RCW AND 296200 WAC. <br />/, � "+ l <br />TYPE OF EOUIPMENT <br />NDLG UNITS—H.P. <br />AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS—D.T.U. M <br />V[NTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE ( <br />FIREPL�CEINSERT <br />HEAT PUMP <br />GAS PIPiNG <br />E%HAUSTFAN <br />SIOESETB�CK PLANf,HECKNUMOER FE[ <br />3� 73� <br />vncaNrsire FEES _ <br />fl VES - NO pUILDING <br />CCLO�ANCY NJ Of6A(LlitiG NIiiS <br />cAouv PLU�dBING <br />BASE6�Eni MECNANICAL <br />C] YES ❑ NO <br />MEiGHiu6VTAnnN ADDITION4LPLANCHECK <br />OTHER <br />STATE BUILOING Sl1RCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAk CQqEIS 3105 rorni <br />5 <br />RECEIPT NO. <br />FEE <br />0 <br />