Laserfiche WebLink
APPLICATIOC FOR CONSTRUCTI � N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />fhe EwrOreen <br />CI7Y OF <br />everett �-- <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />Q�ER MAtLADDRE55 <br />_ .. � , �. <br />HEATING SYSTEM: O GAS ❑ ELECTRIC ❑ <br />BUILDING <br />GTV <br />MECHANICAL <br />21P PI <br />��a�� <br />ZIP PI <br />PMONE <br />PLUMBING SIGN <br />� `�. � `�. � � <br />JO ' � 4J(a'� S Z1TR..��A 'W J'a�+o— rn�—� �• • <br />GENERALGONTRALT MAILAODRE55 CILV 21P U PHONE IiCENSE/ <br />IAECNANICAL GONiNACTOR MAIL RDDRE55 QTY 21P PHONE LICENSE • <br />PLUMBtt:GCONiRACTOR MAILADDRE55 <br />CITV ZiP PNONE ULENSE � <br />GUSSOF WORI( <br />..�, NEW �. ADDITION . ��. AITEflATION �✓REPAIR <br />LECAL otscnu• u�n �r rn..�..,. �.,.,. •...... ____. <br />�p� BLOCK OF <br />,�5� U1 Vr%�l� (C� / <br />31NG <br />TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASM) <br />SNOWER <br />KITCHEN SINK & DISP __ <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIfJ <br />BACKFLOW PREVENTERS <br />RUOF DRAINS—RAINLEADERS _ <br />SINK (SEflVICE—BAR, ETC.) <br />SUP TOTAL 5 <br />PERMIT $ <br />TOTALFEE $ <br />FOR OFFICE USE ONIY: <br />USE <br />LVPE Of LONiS. FIIOWABI[ 1VPF Oi GONSi AGI <br />92[ OF BLDG N0. GF STORIES <br />OCCUPANCVIORD FIRESPRNNLER: <br />INTANEBV I �UNSAPPROYEDBY <br />.'� DEMOLITION . WOODSTOVE/FRPL INSERT ��_. BUILDING RELOCATION <br />� COHTPGT PERSON RND PMONE t!O <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TqUE AND CORRECT. ALL <br />coviesi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN Ofi <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF FNY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PFOPEflTV TO PERFOFM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br />SIGNATUREOFCONiriRCTOR00RlITMORREORGfNT D�TE <br />X —T-•� �V�7�� 0 , l, Cl \\ �, <br />qPpLICaNTS Gltt BUSINE55 UGCNSE NO. AND BUSME55 NRME <br />UNIT HEATERS—R.T.U. M <br />FAN <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING _ <br />E%HAUSTFAN <br />M E.A. <br />SUBTOTAL $ <br />F'ERMIT S <br />TOTALFEE ff <br />£IOESEiBACK PLANCHECNNOMBER �EE I RECEIPTNO <br />VALRNTSITE _�rcw <br />BUILDING <br />wcu=.xcr xoaonm�eauxns <br />aaouP PLUMBING <br />BASEMENT MECHANICAL <br />NEIGHT LIM�TATION ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHAflGE <br />CITY Of EVERETT PUP.LIC WORHS <br />LOCAL SALES <br />TAX COUEIS 3105 TOTA� <br />�X <br />A <br />