Laserfiche WebLink
� <br />fAe Everpresn <br />i CITY OF <br />: everett <br />BUILDING DEPARTMEN7 <br />269•8810 <br />� �i ��: <br />APPLIC�ION FOR CONSTR�TION <br />F�ERMIT <br />TO BH COMPLETED IN INK— PL[ASE PRINT <br />�{ICHRECfORDE51pNER M�IL�UUPE55 GIIY 21P PNONE <br />evere[t <br />� <br />❑ NEW ❑ ADDITION uy � <br />\� TEN�NTIMPROVEMENTOR�NTERIORREM <br />/` CONT TPflICEOF RK <br />� WORK11 U�REf O <br />X - <br />� eouse v uamNo <br />, `. LEOAlOES/C�N TqNOFP P ttISH <br />� " LOT�.Z`SL lLOCN__ dF <br />�'i'�%/7l <br />, � <br />DISHWASHER <br />UUNDRVTRAY <br />/�LLOWABLE/�CTU�L <br />flRE <br />�O FOUNTAIN <br />DRAIN <br />.OW PREVENTERS <br />�RAINS — RAINLEADERS <br />COVIl:F—RLR FTCI <br />TOTALFEE <br />YES ❑ NO <br />❑v <br />❑ N <br />�.; <br />j <br />❑ REPAIfi ❑ OEMOLIiION ❑ WOODSTOVE/FPPL INSERT ❑ BUIl01NG RELOCAIION s <br />/) CONi�CTPEt1SON�NDP110NEN0. � ;` -�{:� <br />AV(/ . __ . . ,�'S. <br />1 <br />M <br />� ::.� <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPIICATION AND <br />KNOWTHESAMETOBETFUEANDCORRECT.ALLPROVISIONSOFLAWSAND � , <br />ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH �� � <br />WHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOFAPERMITDOESNOT � <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL lAW REGULATING COI�STFUCTION OR THE PER• <br />FORMANCE OF ONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THISPR NT RFORMT�WORKFORWHICHAPPLICATIONISMADE .:�; <br />AND COMPLV THE ST CONTRACTORS LAW 1827 RCW AND �� <br />296. 00 WAG � ^' <br />510 ATUREO�CON nnnnui�� iZE0P0ENf OAtE <br />�i <br />X� <br />pPPV CANiS pl' <br />MECHANICAL <br />FEE NO. <br />eic—, <br />TYPE OF EOUIPMEN7 <br />JLG UNIiS — H.P. <br />I SYSTEMS — &T.U. M EA <br />RS—flT.11. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />PLACE d CHIMfJEY <br />INSERT <br />:j <br />v�cnrvr sire FEES <br />❑ YES O NO <br />BUILDING <br />NO.OF OWELLINO UNIB <br />PI.UMBING <br />OCC LOnD <br />MECHANICAL <br />NEIpNTLIMITR110N QTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGV SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />TOiAL <br />a <br />E <br />r <br />FEE <br />NO. <br />FEE <br />fN3. <br />� .� <br />�� <br />� <br />., <br />; . . ti . <br />i ', i;; <br />� <br />� ' ' n <br />S -G' I <br />i � <br />t <br />.. '. �'.�1. <br />� �3' iI <br />. ' '�^^'SI1 <br />