Laserfiche WebLink
� <br />BVl'fP:i <br />t°!a,PPLIC�►Vf��r.+�1�OR CONSTR�JC'Y'I�i'N PL�R�'��T <br />t �� V <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />Ihx Evergrren <br />CIiV OF } __ � <br />errer�ei� HEATING SYSTEM: IJ GAS ❑[LECTRIC U <br />BUILDING DtPARTMENT <br />259•8810 <br />C1 DEiNOLITiION I i COMBINA?ION <br />QW Eq e+nu nooness <br />�C d, —�'v �' t�l.�_��'�� <br />.�.,.,, Mni�nomvr.ss <br />i BUILDING <br />CIIV <br />�.)._. 4 � �� <br />CIiY <br />ARCHIiF.CTOFl0E51GN[fi MAILADI1RE55 <br />cirv <br />MML �DORESS ��� � <br />GENEP4LCONTPACIOR r' <br />C�> ��.�= l� C �. (,�I J �� ��.-�1`.i`—�.�� -� <br />MECHANICALCONIMCIOR MNL�D���SS <br />_— _—"- �— CIIY .— <br />PLUMBINGCONIR�CIOR h1411��P�ESS <br />' MECHANICAL I ' PLUM9ING <br />nr ruorie <br />( �l �i �,1 �' `. � 1� J v� <br />nr ruoNe <br />nr r�wue <br />71P �'.IOHE <br />, �'lI (��3'�_ <br />im rnoNe <br />ZIP PIION[ <br />LICENSf < <br />� � 1 j <br />4ul <br />LICENSE tl <br />LICENSF. u <br />:_I SIGN <br />( <br />CLPSS OF WOfiN I � <br />I I NEW I I �DDITION �`i ALTERATION '_fiEPAIR __' � DEMOIJTION _ WOODSTOVE�PRPLINSERT I I BUILDWGRELOCATIO <br />—� �CONIACIPFIISOf�NN1'110N@NO. <br />cor+rr+ncr vnice or wonK <br />'�l << ���,ll'�� � , ., �,_��.� <br />DESCRIBE WO(liN ANU SOU�f1E f W1AGE IN'%OLVEO 1 <br />r. L•��4r'+��'� 'l �L�ri�l LJ,��\ 4�J"'P� :��.,,•�� <br />VROPOSED 11+F OF �UIIDING <br />� �r f- — <br />I[����� �' LEG�LOESCRIPiIONOFPB01'ERIY�5110\YNf1ELOW0(iAIIACNroU�CGPIE51 <br />11+� '� LOT BLOCK �F _ <br />i <br />PROJECI ApUf1E5s , <br />�J� � ) (/ �. <br />NO. TYPE OF FIXTi <br />WATER CLOSET{'101L <br />BATf�iTUB � <br />LAVA�ORY(WASH BA; <br />SHOWER <br />KITCHEN SINI<& DISP <br />DISHWASHER <br />LAUN�RYTR�Y <br />CLOTHES W�+SHER <br />URINAL <br />DRINKING FOUNTAIN <br />�LOOR DRAIN <br />ROOF <br />I HER[81' CERTIFY THAT I HAVE READ �ND EXAMINED THIS <br />APPLICATION AND KNOW TI IE SAM6 TO BE TFUE AND COflRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI �E COMPLETED WITH WFIETHER SPECIFIED HEREIN OF <br />NCT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTfiORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING COfJSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTV TO FERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CUNTRACTORS LAW 1827 FCW AND 296.200 WAC. <br />sicrinwneorcournncionor+nun+onizeoncerir onTe <br />� <br />AI'Pl ICAII � S f:� I V 01 i:Illl'^.•: I ICFNSf NP �ND IIUSMESS N�MF �—"'"-- <br />OR ITEM FEE NO. <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE US[ ONLY: _ <br />f(i'JN�SE77ACK �U(15E7E1nCK 9UFSPIOACK <br />USE ZONF �1 �f1E4 "' ---�—�VACnHI SIIG -- <br />IVPE Oi CON�S. AI LOVlAPI [ <br />512E OF �LUG <br />OCCUPANCYLOAD <br />REA501! FOR SPIllN1:lER9 <br />ir�rnHE or <br />TYPE OF SCUIPMENT <br />IVC-- Nf INDLG UNI �S --H.P. <br />FORCEU�IRSYSIEh1S—B.T.U. M E.A <br />UNITIIEAIERS B1.U. M <br />CLOTIIES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />W.1TER HEATER <br />WOOD STCVE <br />METAL FIFlEPLACE 8 CHIMNEY <br />RREPLACE MSERT <br />IiEAT PUMP <br />GAS PIPING <br />EXIiAUS I' FAN <br />PL41! CI IECK 1l116V1P1 <br />nun.owc; <br />. — --- -- <br />lYPH1fClRlSInCI1l01 ncmm�urr nno�nwuin+riums <br />r.nnnr pLUM[11NC: <br />_. <br />. _ _.__ _ ..._._...__... <br />NO.Of SIORIES �-"_—" � � [145EM1tfill �/IF.I:IIANICAL <br />AUUITiONAI. PLAN CI IC-CK <br />fIPESPfIIlKLEf15RGOD HFIGIIIUMIIAIION _ ____ <br />OTHER <br />ST�TE OUII.UING SUHCHMGE <br />rinu nr�noveonv CITYOFEVERET7 runi.icwor�Ks <br />J� J�' � LOCAL SALES <br />/� /�1 TAX COUE IS 3'105 TOTAL <br />—_. _ i-- <br />SUB TOT�L 5 ' _ <br />PERMIT 5 � <br />TOTAL FEE 5 ' <br />rre neceirrrio. <br />C� <br />