Laserfiche WebLink
� � � <br />� � <br />ti <br />H N <br />�oH� <br />�OM� <br />� O � <br />OnH:�{ <br />Q` � <br />�py� <br />M� <br />f'1 � <br />N <br />� <br />� V � <br />d1PPLICATldr1 FOR CONSTRUCT�ON PERMIT �-�"�'� <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />rnn 6m�grron <br />CRY OF <br />everett � <br />Bi11LDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />CKN[H M�RADDlIE55 <br />Li�S-RL���1-t�i�' i�`� i�`�S��i�� <br />1ENANr"' MAILADDR[55 <br />Ar..��rtELTORDESIGNEH MAIL�DDRE55 <br />G[rv[RALCONTPRGtON MAILPI]DRE55 <br />MECH4NICPLCONiR�GiOP MAILApORE55 <br />(° M rI <br />PWMDINGCONTfl4Ci�1R M��IL/R��HESS <br />Ce.�1L TTI`C��ll� �4���� ��i1 <br />ClASS OF WORK <br />HEATING SYSTEM: �!I GAS ❑ ELECTRIC J <br />BUILDING <br />CIiY <br />P oc Ps-ri <br />GIiY <br />..�� NEW . � ADDITION .� ALTERATION _: REPAIR <br />J�/. � L <br />GONiRACT Pfi1LE Di WOiiH ��/ `� � C' __ <br />DESLRIB[ 1VOAK RN� SOUAJi[ FOOTAG �INVOLVEO <br />IEGFL DESCPIPTION Of PqOPI <br />LOT _ BLOCN <br />WATERCLGSET(TOIL <br />BATHTUB <br />LAVATORY�WASH BA`. <br />SHOWER <br />KITCH[N SINK E DISP <br />DISHWASHER <br />LAUNDFYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUN?AIN <br />FLOOR DRAIN <br />OF <br />FOR OFFICE USE ONLY: <br />FPONTSEiBACK R[nRSEiHACh <br />US[ZON[ LOTARER <br />SRE OF BIDG <br />RGASONfORSPRiNKLERS <br />W 1AnE BV <br />Yi�LI <br />SUB TOTAL <br />PERMIT <br />IYPf Of C�NSI AC7UAl <br />NO. OF STORIES <br />REOD <br />av <br />GIiY <br />pTY <br />MECHANICAL <br />(2/1P ^P^MO E <br />l �� �= < l ` <br />IiP PMONE <br />Zi� PNONE <br />j�p FMONE <br />21P PMONE <br />ZIP PHONC <br />PLUMBING <br />LICENSt • <br />IICENSE t <br />UCENSE• <br />SIGN <br />DEMOLITION '. �. WOOUSTOVE/FRPL INSEflT ��_. BUILDING RELOCA?ION <br />(I 60�t 1AC7 PEPSON RND PyONE NO 1 _ <br />I HEREBY CERTIFY THAT I HAVE READ AN� EXAMINED THIS <br />APPLIGATION AND KNOW THE SAMF TO BE TRUE AND CORRECT. ALL <br />Four+coaiesi PPOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED NEPEIN OR <br />NOT. TH[ GRA•�TING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATWG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORM TNE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />—G9NTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />SiGN�URE OF CONiFACT�Jii O� HORIZED AGENT DATE � <br />�c���jt?�/ <br />%- � � - � <br />� <br />�� /% � � -' � . �G < <br />I APPUCPNTSCiiVBWINE551GhN5ENO�NpBUS E59NAME <br />A/C—NHNOLG UNI fS—H.P. <br />FORCED AIR SYSTEMS—B l'.U. M <br />UNIT HEATERS—B.T.U. M <br />CI.OTHES DRYERS <br />VENTILATION fAW <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE:NSERT <br />HEAT PUMP <br />GAS PIPING <br />ExHAUSTFAN <br />$ <br />SiU[ $[104CK PUNCRtCv NU41NU1 � <br />vncnrvr srtE FEES <br />BUILDING <br />IXCOMVC� 40M�NLLIiyGU4���5 — — <br />ppQp° PLUM�ING <br />pASEMENT MECHANICAI <br />4EIGHT LIMI1Pii01! ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OFEVERETT auouc woRKs <br />LOCALSALES <br />TAX COUEIS 3105 rora� <br />PERMIT 5 <br />TOTALFEE $ <br />r�E <br />J i ��"� <br />FEE <br />