Laserfiche WebLink
pppL11.AT10N FOR CONSTR�JCTION <br />PERMIT <br />Il�e E�tiryreen <br />CIiY OF <br />everett <br />BUILDING DEPARTMENT <br />zse-eaio <br />C� <br />evcretl <br />e <br />TO BE COMPLETED IN INK - PLEASE PRINT <br />cnv $1r _/7!/S'!J"i� <br />"�Stc/ �»i t,s�/�p ?.�� 9�'Y3 <� � , <br />cnv — - nr 19�ONE ; <br />SL _ �'�',Cc/L �L�i� ��r_2C'L <br />.,, rir PiIONE <br />M�LLnODP[55 CIIY '---'-"-1iP PI�ONE IICENSE• � <br />OENEP�LCONTfUGTi3<-/ ,) ___ — �'� <br />// <br />Y- <br />MECN�NiC�LCONTRAGTO MML�DDRC55 <br />GLY 21P PIIONE Uf.ENSE • <br />PLUMBIHOCONTP�LTOR <br />M��l �ODRC55 ��1� ��� PI�ONC IIGEN3E ♦ <br />;,usaorwvnn <br />� ryEy/ ❑ AODIiION ❑ �LTEHATION REPAIR ❑ OEMOlITlO ; CoO^CWO g�oN�Non o�+e yo ER� BU�DING REL ATI + <br />�� p�p�K ol <br />►WM�INO <br />FlRE <br />:•]i <br />FEE <br />— 0AR ETC1` <br />SUBTOTAL S <br />PERMIT t <br />TOTAL FEE s — <br />PEAHSEfB�GN 510[5[lO�LN <br />— iotenw VAG�Ni511E <br />�I VCS Il HO <br />WCIIP�NLYGPOUP NOOfOWElUN0UN11 <br />NO OFS10WE5 OSMi. OCC LOAO <br />❑V <br />❑N <br />��eic�n unnurior� <br />i c� res n No ___ <br />1 HEREBV CERTIFY TMAT I I1AVE READ AND EaAMINED THIS APPLICA�ION AND <br />KNOWTHES�ME708E7RUEANDCORRECT.ALLPROVISIONSOFLAWSAN� <br />ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE CAMPLETED WI7H <br />WHETIIER SPECIFIED HEREIN OR NOT, THE GRANTING OFA PERMITDOES NOT <br />PRESUME TO GIVE AUiHORITV TO VIOIATE OR CANCEL THE PROV1310N$ OF �� <br />ANVOTHERSTA7EORLOCALLAWREGULATINGCONSTRUCTIONORiHEPEiF , <br />FORMANCE OF CONSTRUCTION. TMAT I AM AUTr10RIZED BY THE OWNER OF �� <br />THIS PRO?EFTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE ' <br />AND I COMPLY WITH TME STATE CONTRACTORS LAW 18.27 RCW AND <br />296200 WAC. ' <br />SIGN�lU11EOFCONIR�QOfiONAU1110R12EDAUGM �ALE <br />;. <br />—� iC ISCrtY{I�USi� SE N BUSiNE55N�ME �� � � <br />MECHANICAL <br />. NO. TYPE OF EOUIPMENT FEE _ <br />— A/HNDLG UNITS — M.P. <br />ICED AIR SYSTENS— &T.U. M EA � <br />THEATERS—BT.U. F1 _ . <br />RANGE <br />METAL FIREPLACE <br />FIPEPLACE INSEF' <br />HEAT PUMP <br />_ _ -- <br />__ _ '__ __ --- <br />SUB TOTAL 5 <br />__ __ _ ____---- S <br />PERMIT __ _ <br />__ _ _ —._—____— S <br />TOTAL FEG <br />BUILD:NG <br />PLUMBING <br />MECNANICAL <br />OTIIER <br />S7ATE BUILDING SURCIIARGE <br />S1ATE ENERGY SURCIIARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />