Laserfiche WebLink
APPLICATIC"'1 FOR CONSTRUCT`"�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM� �AS ❑ ELECTRIC CI I <br />BUILDING DEPARTMENT <br />259-8810 <br />` DEMOLITION COMBINATION BUILDING ,tiMECHANICAL PLUMBING SIGN <br />` p"yJ q� � I�CRYk M�ILADO�E55 �T CITV ZIP PHONE <br />�B7Y�SKi � ���5'S/-��L S�f/ ,�✓EiC{J� �4'1(� 2r�Z—�7% <br />iENANT M lAAIL AODRE55 CITY 21P PNONE <br />��/K' <br />APCHRECTOPDESIGNER b�AILA0�RE55 CITY ZIP �'��ONE <br />CONTOACfOfl MAILA�DRE55 <br />C:TY <br />LIGENSE s <br />C. LN YYLP-' w �. - _ _ _ - • .. <br />MECHANIGAL CONTRAGTOR M�R A�ONE55 CITY � ZIP PHONE STATE UCENSE Y <br />sd.�f� <br />PIUMBINGCONTRACTOR MARApDflESS CiT! 21P PHONE STA7ELICENSEa <br />GLASS OF WOFK <br />. �. NEW ADDITION K ALTERATION <br />�eBc+? �Jn °g <br />CONTRACT �PILE OF WORR �Oy' ! <br />DESCflIBE WOPN AND SOUAflE FOOtAGE INVOLVED <br />C�rv�a-.�.�1f7�I'!G YS���G��� <br />PROPOSE� USyE OF �BWLDING �` <br />/'�(AN�U-1� ����'///5�L <br />LEG�IDESCRIPTIONOFP OPERTV15110WNtlE�OWORAI <br />LOT BLOCH �F _ <br />nooaess <br />>s—��� PI.�c� 5:�; <br />& DISP <br />SINK <br />FOR OFFICE USE ONLY: <br />FRONTSETBAGK REARSETB�GH <br />USEZONE LOTARE4 <br />.voomrnurcennwaxiF IYPEOiLOH51AC7UAl <br />OFBL�G. � NO.OFSTORIES <br />OGCUPANCVLOA� I flRESPRNHL[RSREO'0 <br />INTANE BV <br />REPAIR � DEMOLITION WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />I CONTACT PEii50N AND PHONE NO. _ , <br />I HEREBY CERTIFY THAT I HAVE READ AND E!(AMINED THIS <br />�v APPLICATION AND KNOW THE SAME TO BE TfiUE AND CORRECT. ALL <br />.� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK K'ILL BE COMPLETED WITH WHEI'HER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL T�E PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW P.EGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOFi WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />ITAL $ <br />f S <br />FEE 3 <br />sioe se�enc <br />VACANT SITE <br />I7 G / 5� 1If? � � � <br />� ouswtssi�cer�scno <br />°MECHANICAL <br />NO. TYPE OF E�UIPN <br />- q/C—NHNDLG UNITS— H.P <br />FORCED AIR SYSTEMS—�B. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DFiYERS <br />VENTILATION FAN <br />RANGENOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL PIREPLACE 8 CHI61 <br />FIFiEPLACE INSEFT <br />HEAT PUMP <br />W CHEGN NUMBER <br />/?I� ;IPG% <br />BUILDING <br />ewuou��r uoorow�iuncwnu <br />caouv p�UM6UJG <br />BASEMENI MECHANICAL <br />�+eiGNiuhnrn7ioH /+DDI7IONALPLANCHECK <br />SPRINHLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETY PUBIIC WORKS <br />LOCAL SALES <br />TAX CODE�S 3105 TOTAL <br />TOTAL 5 <br />FEE <br />