Laserfiche WebLink
APP�ICQTiON FOR CONSTRUCT�JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 9820? • 259•8810 <br />f I DEMOLITION f I COMBINATION f 1 BUILDIhG f 1 MECHANICAL f � PLUMBING SIGN <br />PROJECT ADORESS �( <br />yC-%',� ,� � ll� � f' G?L� e JLC ('I-� ![..'! .� <br />OW`NER MAILpDUPE55 CITV ZIP PHONE <br />�//-�> 5'1 _I�S� x_ ._lY �lc �'S 1 PYI�r_, l�r C.%�Nie1T `�-3�'� �1.5��-�/�c"-, <br />TENANT /, MRII.��ORf.55 OIiY IIP PNONE <br />�X�l"eS1 �Q(S��ne( �/O,-�� 1-fzxf /fz�e'.�/oiii- t�U• 9.�'�Ai ��/-8/OC) <br />ARGHITECTOROESIGNER MAIL<OflPE55 Gltt Zlr PHONE <br />�w�wnuww�m m�i�nwneoe un �iY �HONE STFTEl10EN5E• <br />FG�eC:77 %'i1�-'f-l�iUnir' ���_L= 1'YI[;����u�'iir .j �3:a-3��1� E���/_.�Ti°- <br />MECHnNIGALCONTRACTOR MA4ApDPE55 CITY ZIP PHONE STATEUC°NSE� (�(_. U��, <br />� '� I(� }� <br />PLVN�INGCONTP�GTOR MO,II.AODRE55 Cliv Z�P PHONE STaTF.UCENSE� /—/-4� <br />�ESC(iIBE WORK AND SOOARE FOOTAGE INVOlVEO <br />PROPOSED USF OF <br />I.EG/LOESGRIPTIONOFPFOPERTY SHOWNBELOWORATTACHTWOCOPIGS� <br />lGl _ BLOCH _ OF <br />PAflCELTAXI.D.NUMBER <br />CONSTiiUCTON LOAN LEN�ER. PD�RE55. TELEPMONE NlIM9[P <br />TYPE OF <br />WATER C'_OSET i <br />BATHTUB <br />LAVATORY IWASF <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />Fl.00H DRAIN <br />�ACHFLOW PREVENTERS <br />SIIJ�: ;SERVICE �- BAR, ET <br />� SUB TOTAL 5 <br />PERMIT 5 <br />TUTALFEE S <br />FOR OFFICE US[ ONLY: <br />FRCNT PETORCK I CGAR SFiAACK SIDE SETBRCK <br />USFZqVt n IOTAqEp \'ACANi51TE <br />� �% f1VE5 fl NO <br />HEIGIIT LIMIiRTION N0. OF �WEL�ING SIZE OF 9lOGrtI <br />11NlT5 <br />.9- <br />❑YES Il NO <br />HEATING SYSTEM: I-1 GAS Cl ELECTRIC � 1. <br />LONTACt PERSON AND- ✓PH1ONE N0. /��,, <br />�"i':�il9f � I /���T� ��-��1 L�.i�� �.��J._ S 1�C.C� <br />I HEREBY CERTIFY THAT I HAVE READ AND E�(AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AN� C:ORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING l'HIS TYPE OF <br />WORK WILL BE CnMPLIED WITH WHETHER SPECIFIE� HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESv\1E TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISt7N OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANC� OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK Ft�R WHICH <br />AFPIICATION IS MADE AM9 I COMPLY WITH THL- STATE <br />CONTRACTCRS LAW 1827 RCW AiVD 296.20Q WAC. <br />x �l_,C-`Y� 12<. �d � ����_ <br />SIGNATORE OATE <br />/)�8%/U ' �%�12.'SS �/Y`-�c'�Il/IP[( <br />GITV BUSINESS UCENSL N0. <br />MECHANICAL <br />NO. TYPE OF FI%TURE OR ITEM FEE <br />�— <br />A/C - A/HNDLG UNITS - H.P. <br />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />HEAT PUTA? � <br />UNI? HEATcRS - B.T.U. M <br />CLOTHESDRYERS i <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE ( <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 5 <br />PERMIT 5 <br />TO'(AL FEE S <br />PLANCHGC NI:M[IFR FEE c^,� REf,FlPT <br />/ �/, '.�� �" // � = //I <br />BUILOING <br />PLUN6iNG <br />MECNFNICAL <br />ADDITIONAL PIAN CHECK <br />O7NER <br />SiAT[ 9UIIDING SURCH�RGE <br />CITY OF EVERETT PULJC WORNS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />