Laserfiche WebLink
HxOrH <br />b7 [-0 � <br />��x <br />Q H <br />9Hln <br />4 <br />y�H <br />�H� <br />� x � <br />k] h"I � <br />VJ H <br />� 7 � <br />y C7 <br />H [i7 � <br />�i=� (] <br />zay� <br />rHH <br />g�' <br />� <br />(] t7 ti <br />� � � <br />zycn <br />HOtn <br />APPLICATIO.. �OR CON�'iRIJ1CTL �RI PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT e+�Jren' <br />BUILDING DEPARTMENT I HEAT!NG SYSTEM: J GAS J ELEC'RIC J 1 <br />259-8870 <br />DEMOLITION COMBINATION BUILDING MECHANICAL )(PLUMBING SIGN <br />C1V1lEF AIAILRDDR[55 CILY �iP PHONE <br />�) 5ytq�, �r; atii �F�// -�/�' ,Al St Fvs,er-Ft lv,iq 98.zo�/ 3 S 3—�de� l <br />ip1hNT MAiLRD�RESS LITV ZIP PHONE <br />n�CNIiECTORDESiGNER MAiLpDDRESS LITY ZiP PHONE <br />i nn'l� �%7S _ <br />(G�ENERALLONiRACTOR MAiLADDRE55 CiTY ZiP P��ONE STATEIiCENSE• <br />✓Ai' �n.-� JU:'�f Po. P,ox /�You ff,,,,ti', 1 `4.��wao�! � h//f r'J�ot�6 ���N�+-/�7/�lC?_ <br />U.[CNANiCALCpNTNRCTOR MAILAD�RF55 � GTY ZIP � FHONE STAIFLICEGS[� <br />oWMBIflGCONiqACiOR MAILqpORE55 G1Y Zi� oryONE STpTEUL[NS[• <br />Q A55 OF WORK <br />NEW ADDITION ALTERATION REPAIR DEMOUTION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />� COYiACI PERSON ANO PHONE NO <br />FOOiAGE <br />iJT BLOCK OF <br />ri�o�ecrnooa[ss <br />�JGiI_ <br />NO. TYPE OF FIXTURE OR f <br />WATER CLOSET (TOILET) <br />BATHTUO <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />BACKFLOW PFEVENTERS <br />ROOF DRAINS—RAINLEADERS <br />FOR OFFICE USE ONLY: <br />rnorvtsetencK nennserencrc <br />U;[ 20NE lOi PREA <br />IY�'FOfC�MSpILOWnBIE iYPE01G�1�9.AC10AL <br />`;iZE OF pLDG. NO OF STORiES <br />OCCUPANC� LOAD fiqE SPRNrcLERS RE00 <br />cLA50N FOP SPqiNKLERS <br />u, 4KE�V �WSAPPROVEDB� <br />I H[(iE�Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT, hLL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL �E COIdPL�TED WITH WHETHER Sf'EGFIED HEREW OR <br />NOT. THE GRANTING UF A PERMIT DOES NOT PRESUME TO G.VF <br />AUTHORITV TO VIOLATE OR CANCEL iHE PROVISiONS OP ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFi THE <br />PERFORMANCE OF CONSTRUCTION. 7H/.T I AR1 AUTHOR12ED BV THE <br />OWN[R OF THIS PROPERTV 70 PERFORM THE WORK FOR WHICH <br />APPLICA710N IS MADE AND I CO�dPLY WITH THE bTATE <br />CONTRACTORSLAW1B.27RCW AN0296200WAC. <br />A�C—A�HNDLG UNITS—H P. <br />FORCED.IIR SVSTEMS—B.T.U. <br />UNITHEATERS-6.TU. M <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGFHO00 <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />PIREPLACE INSERT <br />HEAT PUh1P <br />GAS PIPING <br />EXHAUSTFAN <br />51�65ET�ACK PIANCM[CkNUMBER �[I: <br />3 7�3 <br />VACAMEiTE FEES <br />BUIIDING <br />ors�nry�r xoprcv;��.nacU,�c <br />cco.io p�UMBING <br />�ASEMENi MECHANICAL <br />HBGHT l�MrtailON ADDITIONAL P�AN CNECK <br />SPflINN�ER <br />SiATE BW��IHG SURGHANGE <br />CITY OF EVERETT i�uouc wonrcs <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAL <br />6A <br />PEC[IBi NO <br />Z <br />