Laserfiche WebLink
�. .� <br />APPLICATIO.� FOR CONSTRUCT�.�N PERMIT <br />r� E�re� TO BE COMPLETED IN INK—PLEASE PRINT <br />ciTv oF <br />everett HEATING SYSTEM: ❑ GAS ❑ ELECTRIC O <br />BUILDING DEPAR' MENT <br />259•8810 <br />�_� DEMOLITION �� COMBINATION _: BUILDING <br />OWNER M�ILADORE55 ��rv <br />.>aeNc��e�i o��P z7oL 1�*�� �d� F�Y�►c/% <br />r uwr M�ILI�DDRE55 CITV <br />- MECHANICAL <br />21P PI <br />�z� 3 <br />ZIP PI <br />���, Z�p PHONE <br />�RCHITECTORDESKiNEP MAIUUDRE55 <br />everett <br />e <br />;= PLUMBING , SIGN <br />�Y P- �S� � <br />-/.�,Zo...�-Fc'l� TMxI 77iT5 <br />„���«. <br />MEGN�NICALCONTN�CTOF � MAIL/�DDRE55 �"' <br />��n, Z�p PHONE LICENSE� <br />PLUTABINGCONTP�CTOR MMLADDRE55 <br />ClA55d�' WORK <br />x NEW f: ADDITION X ALTERAT�ON `.-1 REPAIR <br />CONTP�CT PRIGE OF VIORK <br />�6�v �% <br />DESCRIBEWORNANDSOWREFOOT EINVOlVEO <br />f <br />6/e / n �n P <br />PROPOSE U EOFBUIL�ING <br />LECALDESCRIPTIONOFFHOPERiVISMOWNBELOWO/H���TTACJIF RCOPIES) <br />LOT .3� 6 BLOCK OF //�tvl S MQIfI <br />_ . _ �.. _. % _i 1 �-/ .��..�� <br />0 <br />UFiINAL <br />URINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS–RAINLEADERS <br />SINK (SEHVICE–BAR. ETC.) <br />-- SUBTOTAL $ <br />— � � PERMIT 8 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONT SETBRCN REAR SETB�CK SIDE SETBRG <br />.._...,.... �m�ae• I VALANTSITE <br />�LLOW�BIE <br />LO�O <br />G DEMOUTION �. ���. WOODSTOVEIFRPL INSERT Ci BUILDING RELOCATION <br />LONT�C� PERSON ANO PNONE N0. <br />LONST.ALiUAI DC[pWpc� NOIXVMwMGUNrtS <br />'/� <br />STOFIES B�SEIAENT <br />N� <br />'flNKLER5RE0'D MEIGMTIIMITRSION <br />N� <br />APPROVEO B� CITY OF EYERETT <br />Q,A' LOCAL SIILES <br />-N 9/c TAX CODE IS 3105 <br />I HEREBY CERTIFY tHAT I HAVE READ AND EXAMINED THIS <br />�1PPlICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINAN�ES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEflTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AN7 I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATUREUFGONTRACTONO AUTHORI AGEtlT DATE <br />X � <br />APPUCANTSGI BUS ICElSE O.MI BUSINE '! ME <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />HEAT <br />GASI <br />PUN GNEGK <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PUN CM�_CK <br />OTHEF <br />STATE BUILDING SURCHARGE <br />PUBLIC \VOPKS <br />TOTAL <br />M <br />TOTAL <br />9s'iar' <br />