Laserfiche WebLink
0 <br />APPLICATIC� ��R CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />I HEATING SYSTEM U CAS .�ELECTRIC J <br />BUILDING DEPARTMENT <br />259•8810 <br />DEMOLITION COMBINATION � BUILDING MECHANICAL � PLUMBING SIGN <br />NER M�IL RE55 CI"r 21P PMONE <br />�,L�vsTisoN /'� �c3�K �. <br />TENRNT MRII �UORE55 <br />RBCIIITEQOROESIGH[R . A1IILAOOAE55 <br />CONTP�CTOR <br />_ ,. �. � . . <br />MMt RDDRE55 <br />M�IL ADDRESS <br />v33 <br />CIiY <br />GTv <br />CL SSOFWORI( <br />NEW �ADDIiION ALTEHATION REPA!R <br />CONTRACT PRICE Of WORK �j.<,.�]O �M1- �O /�} c� L� <br />OESCRIBE Y/OFN �ND SOURRE FOOU6E INVMVED � <br />PAOPOSW USE OF BWLDINO <br />LOT <br />�a o <br />PROPEPTY <br />BLOG1t <br />TYPE OF <br />CLOSET <br />KITCHEN SINK 8 OISF <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />ROOF <br />SINK � <br />BELOW OR RTi�CN FWN COPIES) <br />OF <br />� <br />SUB TOTAL 8 <br />PERMIT $ <br />T07ALFEE S <br />FOR OFFICE USE ONLV: <br />FRONTSETBRGN � R[ARSETBAC� <br />Zo Zo <br />USEZON�_� IOTRRER <br />� �1Z <br />IYPE Of LONIS ALIOWABIF 1VPE Of CON51 AGI114L <br />�-tJ J�� til <br />5113��LDGf+ NOOFSTOR:ES <br />' 2 <br />sr Gqnavt <br />OCGUPANCVLOAD �IF[SPRNNlER5RE00 <br />A <br />fi[F50 FORSPRINNLERS <br />rturnKe av <br />b 3/� <br />SE78�CR <br />s' <br />>�;0:3 � 78� G�,�O <br />ZIP PHONE <br />2'P PMONE <br />,w •`� l� ,33 4 cQ (o�i 7 <br />21P PMONE STATE LICENSE t <br />'�c�l`j )�PG�1�v CiusTA�26t49K? <br />21P PMONE SiATE UCENSE � <br />2iP PMONE STATE LICENSE • <br />DEMOLITION WOODSTJVE/FRPL INSERT BUILDING RELOCATION <br />CONiRLi PERSON ery0.'r�ONF NO <br />i HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br />WORK WILL BE f:OMPLETED WITH WHETHER SPECIFIED HCREIN OR <br />NO�. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCT�ON OR THE <br />PERFORMA� OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF HIS PROPERTY TO PERFOPM THE WORK FOR WHICH <br />APPLICA7 pN I�S' MADE AND I COMPLY WITH THE STATE <br />CONTRA- �.ORSJCAW 10.27 RCW AND 296200 WAC. <br />- �5 �- 9� <br />NO <br />TVPE OF EOUIPMENT <br />NDLG UNITS—H.P. <br />AIR SYSTEMS—B.T.U. M E.A. <br />�TERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACE INSERT <br />� l � - � J,7 , _ �-- ,� ; rl � <br />—T <br />SUB TOTAL E <br />I�EHMIT S <br />TOTAL FEE $ <br />I � .� .'j i,P. 4 � <br />3ER/ �EE RFCE NO <br />���, U 3 =� ,3 � oi�� � <br />' `-� BUILDING <br />Cf.C�o�ryl;\ NIIIIfIM'111�MG�N115 <br />�1P 2 PLUMBING <br />B�SEMEr+r MECHANICAL <br />u� <br />NEiaHruMiut�or+ ADDI710NALPLAHCHECN <br />�� SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 rorn� <br />