Laserfiche WebLink
�r7 <br /> � APPLI�ION FOR CONSTR�TION <br /> ' PERMIT <br /> M�Er�ryn�n everett <br /> qTY OF � <br /> � �verett <br /> � `BUILDINQ DEPARTMENT <br /> 266�6810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> .� 1 /� 6WL• E99 GTY ZIP PMONE ', <br /> �� /� (v 'ft�[� C✓ea�i� �M.wO. 3��� g(opddilY �Jtr� �{8Lv1 2, s8�-6��)� '� <br /> n/UNT GMIL�CDRES9 CITY 21P PNONE 1 <br /> � S�Odle /45 AB�v+� <br /> � �N�y,DEBM�A �YC� IMIL��DRE53 /✓L✓t� l�Z�' h�IONE 2�� 'qI `I <br /> F ./ <br /> • �. � �p��p�Oq IMIL�pppE88 � CITY 21P PHONE LICENlE• <br /> �j �hw.lw�r �onsf �tor�! Zo* 5� ,Fyr•'�tJ 9'�Z�S 33�1-7��� . <br /> � MEpIFNIC�LCONTMCTOR M�ILAOUPESB GIiY 21P PNONE LICENBE• , <br /> 1 <br /> ��� KUMMNOCANTMCTOR �/� MAILADDRES9 CITY 21P ��E UCENSE <br /> I <br /> 1 CW6WNORN � <br /> j ❑ NEW ❑ ADDITION ❑ ALTEMTION ❑ FEPAIR DEMOLITION ❑ WOOD9TOVE/FRPLINSERT ❑ BUILDINaRELOCATION <br /> T[IMNT IMMq/EMlNTOR INT[RIOR MlMODEL ONIY CONTI�Cf VERlON N!D PHONE NO. , <br /> ' +� a rlrC.� 206 �j3`/-���� <br /> � ,, ppAMCTMIIC[OFMOIIK vJ/� F <br /> WpIK/JIDlOUMf�OOTAOE INVOWlD <br /> i <br /> � nq�oseuueeawaoiHO IHEREBVCERTIFYTHATIHAVEREADANDE%AMINEDTMIBAPPIICATONAND <br /> KNOW THE 9AME TO BETRUE AND COHRECT.ALL PROVI&ON80F LAWB AND <br /> +� � OPDINANCES OOVERNINO THIS TVPE OF WORK WILL BE COMPLETED WIiH <br /> � D[�qll/IIONOFPIIOPERtt(ONOMNSELOY/ON1ITT�CNFOURCONEW yyHE7HERSPECIflEDHEREINORNOT.THEORANTINOOFAPERMRD0E8NOT <br /> + PRESUME TO OIVE AUTHORIN TO VIOLATE OR CANCEL THE PAOVI&ON8 0F <br /> . � aoac or ANYOTMERSTATEORLOCALLMNREODUTINOCANBTRIICTIONORTHEPER <br /> � FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> t � TF1�g pqppEqTV Tp PERFOfiM TME WORK FOR WMM.M APPLICATON IS MADE <br /> � � AND I COMPLY NATH TME STATE CONTRACTORS LMN 18.77 RCW AND <br /> 29E.PW WAC. <br /> ,j , BIONATUREOF ONTMCTORONAUTH011REDADENT 0/�1E <br /> � ♦ er �K�CE�?C/ � ��r ( <br /> �� � 2 t9 <br /> i� ,S/�✓� � �•r� Ev �f x , .�! � <br /> j ,�,�� -� <br /> �A + � .�rriy� ITBGTYBU&NE UCEN9ENONIOBU&NE6BIUME <br /> ��v , ��� /� �/ <br /> ��i j k���r�� MECNANICAL <br /> �Ir+11p, ' TYr[ORFIX7UI1l0111T1M F8E N0. TYPEOFEOUIPM[NT �� <br /> t� �T?�� � �"' �WATERCLOSETROIL NC—NHNDL�UNIT9—HP. <br /> :�.n.>... �, y���g FORCED AIR SYSTEMS—BLU. M EA <br /> �� �,i.:.; UNITHEATERS—fiT.U. M ' <br /> UVATORY(WA9M BASIM <br /> �`� ,� SMpyyEq CLOTHESDRVEHS <br /> (� '.�: KRCMEN 81NKi DISP. VENiIUTION FAN <br /> ,� DIBHWABHER RANOEHOOD <br /> ;� �...1,.. • UUNORVTFUV WATER MEATER <br /> CLOTMEB WABHER W OOD STOVE <br /> '� �•��"" URINAL METALFIREPLACEBCHIMNEY <br /> � .��',"�� DRINKINO FOUNTAIN FIFEPLACE IN9ERT <br /> FIOOR OMIN MEAT PUMP <br /> � �' � BACKPLOW PREVENTERS OAS PIPIN6 <br /> + �' � pOOFDRAIN9—RAINLEIDERB EIfHAUSTFAN <br /> 1 <br /> � 91NK(9ERVICE—&1RETC� <br /> i I <br /> i i <br /> ' I <br /> j I <br /> 1 <br /> � 9UBTOTAL S SUBTOTAL S <br /> PERMIT S PERMIT S I <br /> ' TOTAL FEE S TOTAL FEE S ' <br /> � . N PFARBEiMCK &DEBET&1CN RAMCXIGRNUM�[II FL[ MC[IRNO. <br /> � ukxor+e �ot�wu v�owrsrtE FEEB VAIWTION FEE � <br /> � o ves ❑No <br /> � � BUILDINO <br /> � ';lyPIOFCONlL OCGUiMM0�OR0UP NO.OFDWELLINOUNI7H <br /> �� ��'�'LL PLUMBINO <br /> 1 ��.�{pFLLOQ NQOFBTOqlEB BSMT. OCGLOAD <br /> i ., , o v MECHANICAL <br /> � ON <br /> I MEIONTLIMIT�TION OTMER <br /> i <br /> ! ' �IRE/MINKLEN9 PEOUIPED O YE9 O NO $TATE BIJILDINO SURCHAP6E <br /> � <br /> � STATE ENER�Y SURCHARQE � ;�., <br /> i M►LICATIONACGBY PLAN9�PVRBY PUBLICWORKS <br /> � •� <br /> j TOTAL <br /> I <br /> I ,�,.v;�,�;.,�.�,,,�,r,�„" :��..�v�..�l. .:.�\:4.cr� �.,-r ">•• fa'"^f;r.5[ :iijlh::.A. �y,,P...:,�..�5^.",L'ti���:;r,:..��,tp:y;,<, <br />