Laserfiche WebLink
�Pro <br />� � Qi <br />� Z N(� <br />O C O <br />� M �q <br />r� N � <br />C S <br />IE <br />� � � <br />M , � <br />H <br />�] <br />M N <br />N <br />O N <br />� �y � <br />H O N <br />I �� <br />� ��I <br />APPLICATIG J FOR CONS�TRUCT )N P1=RIN11`�' ,� <br />TO BE COMPLETED IN BLACK INIC—PLEASE PRINT <br />HEATING SYSTEM: J GAS �J ELECTRIC J_._ __ _- __ I <br />BUILDING DGPARTMENT '- - <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />—� MNLnCD�[Ss c�iv z�a rHON[ <br />/�'1,..�no,- ����Pf�izs /.F31Z ��*��r �q�e `I��'-�3 339 ///� —__ <br />--7 MAIL A D��f 65 CI TI� 1� PMOY[ �{ /� <br />��yn��t ��'� �VE/tif% Lv/l '/�ZO� 33�–l��� <br />��«c tl S/�T S/� � P �-/3 —_ �i,c �e.- A•a¢- <br />LIiY ZIP PIIDNE <br />qu�:�ailCIj()�ROESiGNER MPiLA[IDRE55 <br />— ` C'� CITV IIP Pl10NE SiAiELCENSC <br />�;i•� nn�CONiRAGIOR MAILADDRC55 <br />j / , <br />� ��T� Z�p PNONE STAi[LICENSEII <br />N�CCHANiC�LCONTflACiOR MMIRDORE55 <br />���� z�p PHON[ STATEl10EN5[� <br />PIUM1IpINGCONTRr1CTOR MAILROORESS <br />CLn550F WOPN <br />NEW ADDITION AI.TERATION REPAIR DEMOLITION WOODSTOVE'FRPL INSERT BUILDING RELOCATION <br />I CONI4GT PERSON AND P��ONE NO. <br />DF <br />IIG <br />LO1 <br />f:[�7 <br />i <br />o�woAK /�,or�_ <br />ANDSOOAR[FOOTAGEiNVOLVED <br />)F BUILDING <br />"i � <br />ION OF PROPERLV ISIIOWN BELOW OF AT1A <br />BLOCH �F _ <br />OF <br />LAVATORV�WASHL+ <br />SHOWER <br />KI7CHEN SINK 8 DI: <br />DISHWASHER <br />LAUNDRVTPAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FUUNTA <br />fLCOR DRAIN <br />FOR OFFICE USE QNLY: <br />fRONiSf.IBACN 96�RSEiFlACN <br />❑SEIONE tOIAFEA <br />ivPE Of CON15 AItOWPBIF �VP[ Of CONS[ ALiOFI <br />9ZE Of BLDG NOAF SiOPIES <br />OCGUPRNCVlOAO FlR[SPPN0.lFR5REC <br />HF450N FOR SPl11NKLERS <br />iN1AkC0Y PLPNSPPPIIOVfDE1V <br />I HEREBV GERTIFY THAT I HAVE READ AND E%AMWED THIS <br />APPLICATION ANO HNOW THE SAME TO BE TRU[ AND COPRECT. ALL <br />coaiesl PROVISIONS OF LAWS AND OPDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COtdPLETE� WITH WHETHER SPECIFIED NEFiEM GR <br />NOT. THE GFANTING OF A PERMIT �OES NOT PRESUME TO GIV[ <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATMG CONBTRUCTION OR TH[ <br />PERFO ANG� OF CONSTRUCTION. THAT I AM AUTHOFIZEO 6Y THC_ <br />OWNE OFI rI PROPEFTV TO PERFOFM THE WORK FOR YJHICH <br />�PP CATI jJ IS MADE AND I C061PLV WITN THE STA7E <br />CON RACT/p W 1827 RCW AND 296200 WAC <br />x V '�— --- <br />...lAl. C4�1. <br />FEE <br />5 <br />SID[ <br />TYPE OF E�UIPMENT <br />A C—��HNDLG UNITS—HP. <br />FORCEO AIR S�STEMS—B.T.U. M <br />UNIT H[ATERS—B.T.U. M <br />CLOTHES DFYERS <br />V[NTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSEFT <br />HEAT PUMP <br />fAS PIPING <br />�UB T� <br />PERMIT <br />TOTALf <br />rmr:ncn I ��« I nccemr <br />�UIlf1RJG <br />acuc�ucr xoo�oeuvvr,wxu ---- — <br />co'�v - PLUIdUING <br />BaSEMENt M[CHANICAL <br />NEIGHTLIMItAiION �DDITIONAiPLANCHECK <br />SPRINKLER <br />STATE Bl11LDING S�FGHANGH <br />CITY OF EVERETT Nuouc wo�Ks <br />LOCALSALES <br />TAX CODE IS 3105 rorn� <br />