Laserfiche WebLink
� � � <br />� H <br />�o' a c <br />� HC t~/1 <br />H 'L � <br />� � <br />� � b <br />N H <br />��6 <br />O H <br />z n o <br />c�i :� � <br />F� y � <br />H H <br />y H <br />� y <br />�y [S <br />H O N <br />/... <br />I �_ ''; <br />�� <br />Ie _ <br />I � w'. <br />r �,. <br />i.._ <br />A�F��.�c,�,�ppN FOR CbNSTR►,uTIONI <br />PERMIT <br />Iha EvorO�oon <br />CITY OF <br />everPtt <br />BUILDI�t? DEPr�RTMF.NT <br />259�8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OYINEH � MAiLApOfiL55 GIfY ZIP MN@.E <br />� CPr`"�f�P E.LL ��L�TZy I h1J�`'1C:Ml.rJYS C�IGi2.�'f`C l-JFi _. <br />uv1 i��tcw�n <br />�.Ipil <br />cocictl <br />� <br />GENERALCONiRA0t0l1 MAllF00RE55 CItY ZIP P110NE LICENSE� <br />`AECHRNILALCONiRACiOR IAAILPDOPESS GIIY ZIP PHONE LIL[NSE� <br />���C M�'ra�5�-�+�'��5 1ti� SCr�-��� j �� -�ig�SS 3�z 3430 METaLI �141 GC <br />PLUMO�NOLON111RCTOR IAiILAODlIE55 GIIY / 21P PIIONE LIGENSE• <br />NEW ❑ AO�ITIOtJ ❑ ALTERATION ❑ REPAIF ❑ �EMOLITION ❑ WOO�STOVE/FflPL INSEPT ❑ BUILDING RELOCATION <br />CONIRACT FN�CE OF WOlIK <br />�J�yra�� �VA <br />�or o�ocK ov <br />Z� S�,-1 C,�Eec-�'t ►-�1��� <br />PLUMBING <br />WATER CLOSEI (TO <br />BATHTU9 <br />LAVATORY(WASH B <br />SHOWER <br />NITCHEN SINKB DI <br />�ISHWASHER <br />LAUNDRYTFAY <br />CLOTHES WASHER <br />URINAL <br />DFINKING FOUNTA <br />FLOOR DRAIN <br />BACKFLOW PREVE <br />I HEREBYCERTIFYTHAT I HAVE READ AND EXAMINEDTHIS APPLICAiION AND <br />KNOW THE SAME TO BE TRUE AND CORREC7. ALL PFOVISIONS OF LAWS AND <br />OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHEfl SPECIFIED HEREIN OR NOT.7HE GRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTFIORIN TO VIOLATE OR CANCEL TI1E PROVISIONS OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCE OF CONSTqUCTION. THAT I AM AUTHORIZED BY THE OW NER OF <br />7HIS PROPERTY TO PERFORM THE WORK FOR W HICH APPUCATION IS MADE <br />AN� I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAC. <br />SIGIiAiUPEOFCONIRACiORORAU11�0lVIZEOAGE�If �AIE <br />X I�'�-�-�-�- 5�15-gq <br />APPLIC�NTS GItY OOS W E55 LICENSE NO. AND BUSIN[55 NAME <br />MECHANICAL <br />OHITEM I FEE <br />sue rora� <br />FIPESFpINHLEflSBEOWPEO ❑VES ❑NO <br />VJ�4v1 <br />r .vr.�: -. .., ..::' -:.,. <br />A/C — A/HNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS— 9T.U. <br />IINITHFATERS—flTll. M <br />VENTILATION FAN <br />R�NGEHOOD <br />METAL FIREPLACE 8 <br />GAS PIPING <br />E%HAl15T FAN <br />s <br />$UBT�T/�� Pu <br />PERMIT 5 <br />TOTAL �EE S <br />FEE HECEIPTNO. <br />VALUA710N FEE <br />❑ YES ❑ NO --- <br />euaowc <br />NO.OF pWLLLINO UNIiS <br />PLUMBING <br />osmt. occ�ono <br />❑ v ldECHANICAL <br />❑N <br />HEIGMT�IMIiAiION OTHER <br />— STA7E BUIL�ING SURCHARGE <br />STATEENERGYSURCHARGE <br />� PUBLIC WORKS <br />TOTAL <br />