Laserfiche WebLink
0 <br />APPLICATIO�� FOR CONSTRUCT► �N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />❑ DEMOUTION ❑ COMBINATION ,B BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: �� 2�Z �nl, �'-l�p�,� � Vi o�d ,J7,c' <br />OWNEP Mul�00nE55 Cltt IiP PNONE <br />!��/Z/�XG_O /iS/G SM�4f ZS`� :SS�,�.S <br />TEW�NT MNL�OOi1E55 CIIY )IP CnONE <br />ARLMTECTOiiDESKaNER MMl11W�E55 Cltt )ip PHONE <br />r�Ltf L�2 22 r <br />'///o e f �/ �ta <br />LITY <br />�'r.�2viwc[�' <br />r.�n � rm <br />PiIONE 51ATE LICENSE � <br />i t�s-9 -sd y9 13.�' 2-�LB /i3�3 j <br />PIIONE STATE LICENSE � <br />X/OiY ? <br />PLUGBMIGCONiR�CTM Y�IL�OORESS CIfY 2ip P110NE STATELICENSE� <br />CONTMLT <br />OESCRI!1F WORN 11N0 SOU�IiE FOOT/�E INVOIVED <br />ior eiocK <br />CONSIIKICTION IONI LEkOER. �OORE55. TEIE%IdlE MI4BER <br />J :lu� <br />TYPE OF FlXTURE OR ITEM <br />WATER CLOSET (TOILEn <br />BATHTUB <br />UVATORY (WASH BASIN) <br />SFIOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />ROOR DRAIN <br />BACKPLOW PREVENTERS <br />SINK (SERVICE — BAR. ETC.1 <br />FOR OFFICE USE ONLY: <br />iROHT%TBACI( pEMSETBIICN <br />USE iONE <br />HEHiHT LIMITATION <br />n%J <br />FIRE AURM I <br />No <br />SUB TOTAL S <br />PERMIT f <br />IOI�REA <br />NO OF OwELLING <br />UNIfS <br />�SIptlES OCCUPANTLOAD <br />� �' � <br />FEE <br />SIDE SETB�CN <br />V1ICANI SITE <br />❑YES ❑ NO <br />StIE Oi BLIXLf I <br />Nq <br />BASEMENT <br />❑YES ,0 NO <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONT�CT 1'[RSON �NO PHONE NO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR IOCAL LAW REGUUTIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICF! <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CANTRACTORS LAW 1827 RCW AND 298200 WAC. <br />�� <br />�%<<C� � � �%� <br />N� RE q� ^ D�TE <br />C1TY BUSINE55 tICENSE NO <br />MECHANICAI <br />N0. TYPE OF EOUIPMENT FEE <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES �RYERS <br />RANGEHOOD <br />WATER HEATER <br />WOOD STO�'E <br />MEfAL FIREPLACE (WO( <br />FIREPLACEINSERT(WO <br />GAS FIREPLACE <br />GAS RANGE <br />SUB TOTAL S <br />PUN CIIECK NUMBF:O � FEF � RECFIPT NO <br />nminwr p p,'j <br />rwuou+c <br />MECI1�NIf.M. <br />•D�IIION�LPI�NC��fCN , <br />ome� <br />suic ounowc sunciunce <br />°"".""" '"i �°• CITYOFEVERETT runucwonns <br />� , / � LOCAL SALES <br />Ir v o� S,� j-41 TAX CODE IS 3105 7o7A1 <br />