Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />�fpll <br />;.=1}, : t <br />APPLICA��InN FOR CONS7RlivT10I�1 <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE Pii1NT <br />48a 7� s7s <br />��yJ� ��v�rrTics �o�% 1Y�a� �ve+c"jj' %8�{b% <br />�fICOYIIECtOdpESIGNER MRILROUPESS �ILY 21P PNONE <br />cvcrel� <br />� <br />OENERALCONTRAGiOR MAILA��PE55 pTY ZIP PI�ONE UGENSE• <br />NEW ❑ AODITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOO�STOVE/FRPL INSEHT ❑ BUILDING REIOCATION <br />PflICE OF WORK <br />ior <br />PLUMBING <br />o�ocK oF <br />OR ITEM <br />URINAL <br />DRINKING FOUN1 <br />FLOOR 09AIN <br />BACKF�OW PREV <br />ROOF DRAINS — <br />SINY. (SPRVICF — <br />SUB TOTAL <br />PERMI7 <br />TOTAL F[E <br />ALLOWAC' J�CTU�L <br />O <br />OY <br />FEE <br />.� ' <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA710N AND <br />KNOW'HE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS i.NO <br />ORDINANCCS GOVERNING TFIIS iYPE OF WOPK WILL BE COMPLETED \'/1TH <br />WHETHER SFECIFIED H EREIN OR NOT. THE GRANTING OFA PERMI7 DOES NOT <br />PRESUME TO GIVE AUTHORIN TO VIOIATE OR CANCEL THE PFOVISIONS OF <br />ANY OTHER STATE OR LOCAI LAW li'eGULATING W NSTRUCTION OR THE PER� <br />FOaMANCE OF CONSTRUCTION. THAT i AM AUTHORI2ED 9V THE OWNER OF <br />iHIS PROPERTV TO PERFORM 7HE WORK FOR W HICH APPUCA710N IS MADE <br />AND I COMPLY WITH THE STA7E CONTRACTORS LAW 1827 RCW AIJD <br />296.200 WAC. <br />SIGNRiUREOFGONLRACTORORAUTHORI2EDRGENT DRiE <br />/1 <br />X 7-a/-$9 <br />� <br />nPPLIC�NBCIiYBI/5ME55lICENSE .RN�BUSMESSNAME <br />MECHANICAL <br />Nq. TYPEOFEDUIPMENT <br />02 A/C—A/HNOLGUNI7S—H.P. <br />FORCEDAIRSYSTEMS—BT.U. MEA <br />UNITHEATERS—B.T.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEhTER <br />W OOD STOVE <br />METAI FIREPLACESCHIMNEV <br />FIf1EPLACE INSERT <br />HEAT PUMP <br />GA5 PIPING <br />O YES ❑ NO ' <br />NO.OfDWEILINGUNIi9 BUILDING <br />PLUMBING <br />esuc occ�oao <br />❑ � MECHANICAL <br />❑ N - <br />11EIONTLIMII�IION OTHER <br />STAtE BUILDING SURCHARGE <br />STATE ENERGV SURCHPR^vE <br />� PU6UCWORKS <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />VALUATION <br />S <br />S <br />S <br />ncceirr r�o. <br />FEE <br />