Laserfiche WebLink
� <br />APPLICAiION �R CONS'�t'i�UCT10`°" PERMIT ��� <br />TO @E COMPLETED IN BLACK INK—PLEASE PRINT �` � <br />., x � � - BUILDING DEPARTMENT � . . ' � IEATING SYSTEM: � O GAS � ELECTRIC ❑ _ _� <br />t�' y 259-8810 � <br />q� H ❑ DcMOLITION Q COM�!NATION ❑ BIiILfJING ❑ MECHANICAL O PLUM[iING ❑ SIGN <br />.�y y N OYRlER .1. IMILR�Of1E55 :IN ZIP � PHONE <br />l: .- <br />H � ( <.<r �.r�v (^�� �;fr. ..+� '.c.o; �"'"l:�c.� ({rl�oi,;� � ��C,�.,-,��. � v,:�? `iS J- 3�)-7 k . <br />K' Q TENANT ILMOFlc55 l( CIN 21P YHC'IE <br />o�o �tl�e ('ane��c 69"1 STanNo�2 �S�uO T�Kw��P `i81RK S"1-�r'�?'rbL7 <br />� F'i �U � ARCHITECTONJESIGNER AUILPODFlE55 GTY ZIP P110NE <br />H� H �-! 1huo� S�^'� E A.$!1 �C�o�!' <br />� 7"' � GENEBAI.CON �ILRODRE55 CIN ZIP . PIIONE STATEI.GEHSEI <br />�d G97 LL�u 6' �l<'� �Am� AS /�(��vF Rt�rnc�oE'r io�.DT= <br />O N CIN ZIP NONE STnlh VGE65E I <br />� � � I.IECHANICALCGNTBACTOR IAAI! AD�RE55 <br />(�] Y (7 <br />PLUMOINpCONTRACTOR MAILADOOE55 Cltt 21P PHONE STATEI:CENS'ct , <br />�y� ALLPHRs` PL�mbinlG �-�K's � rJE R�-h 5�++443 f�n l�w�� �+�fo53 �G�,��=—Auvt+� ���'r'o <br />CLASS OF WOPN <br />t7 (N H ❑ NEW ❑ AODITION � ALTERATION U REPAIR ❑ �EMOLITION ❑ WOODSTOVFJFRPLIP.SEPT ❑ BUIL�ING RELOCATIDN <br />� � � GONTACTPERSONANOPHONENO. <br />��� CONTMCTPPICEOFWOF'C �d.� 6Uc' �1 1-1 MUOn.E' S 7� %�C`� <br />y� DESCRIB:WOflNAND50U�WEF00TAGEINVOLVEO <br />Hofn � �,.nr•,"�'� �^.v, �0 2.nen� <br />-�� BUILAWG ..• ' H EOY C[RTIFY THf�T � HAVC- flEAD AND EXAMINED "fHIS <br />.h.y ��T P�� � a <br />u nc oonosan rcunwu PFI otv ON ATTALH FOUfl COPI[S� <br />lOT BLOGK <br />A�OF.ESS <br />G <br />fL00R DRAIN - <br />L <br />FOR OFFICE USE ONLY: <br />ZONE <br />INTAI(E BY <br />��� <br />OF <br />FIfiE SPRI:KlEflS flE0'0 <br />�U <br />i <br />P WIS APPROVED OY <br />FEE <br />�. Su itc <br />I �R <br />APPLICATION AND KNOW 1'HE SAM�: TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF 1A1V5.AND ORDIN>NCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITN WFIETHER SPECIFIED HEREIN OF; <br />NOT. THE GRANTING OF A PERAIIT DC�F.S NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLA'E OR C•1NCEl. THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAN! RE.GULAiING CONSTRUCTION OR THE <br />PEflFORMANCE OF CONSTRUCT�ON. THAT I AM AUTHORIZED BY THE <br />OWPJER OF THIS PFOPERTY T(J PERFOFM THE WORK FOR WHICH <br />APPLICATIOtJ IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS IAW 1827 RCW AND 296.200 WAC. <br />x /L,-� 3 1 io/9� <br />sww.rune wre <br />3 S-�� � <br />;ulT SITE FEES <br />BUILDING <br />�pµy,y NO.CIVMIIWGVx�iS <br />A� ' �- PLUMBING <br />iEI.1ENT A7ECHANICAL <br />�.�U Ci�i9NE� <br />ICHTLI611TATION A��ITIONALPLANCHECK <br />SPRINKLER <br />STA7E DUILDWG SURCHARGE <br />CI7Y OF EVERETT PUOLICWOflKS <br />LOCALSALES <br />TAX CO�E IS 3105 rora�. <br />M <br />M <br />5 <br />fEE nmeirirv�. <br />�77.� G3aay <br />VALUATION FEE <br />1�JMY1 � /3.�! o� <br />� � <br />/3915 <br />J <br />