Laserfiche WebLink
APPLICI�TI�.N FAR C�NS'TR6lC'► �Old ia�RRAI�' <br />CITY OF EVERETT • DUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS:_ 6,� O� Cyti/�'CQQ7ti C(�LY.(,� ^�.(�''Y� �/ny, <br />./� MRILAOpf1E55 LI�Y 21P p110N[ 3u�/733 �� <br />�1rn ��/�i �S'cL a er�rr+r� Wu, �de/�c1�ul.s�— 9P�j�? .5?yo u3a �l,�ir,J�__ <br />TEN� � �-�y ui�noness � i enr nr / riioe�e '�S�'%'-1%���t <br />��lanoh Vof/q�sd.,� %/�/la,s; l�cw,'fc �ino�>�skk029�'0076 �i.�%7,2s89hn, <br />Aq�HITECTOR0E51GNER MRII�pORE55 CIiY NI P�IONE <br />GENEMt CONTReGT0t1 MULADDRE55 GiY �ip PnUNE SInIC IICENSk � <br />MECHl1NICAlCONTRACTOR MAIIADDRE55 Cltt zIP PIIONE $T�TEIICENSE� <br />PIUMBINGCONIRAf,70R MqUDDRE55 CIiY IIP pMONE $iAIELICENSE• <br />�ot <br />PMCEL <br />AND $OUAPE FOOTAGk INVOWED <br />i�u�7 <br />BLOCI( <br />CONSTPUCTION IOiV! LENDER. A WRESS. TELEPHONE NUM9EN <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET (TOILET) <br />BATHiUB <br />SHOWER <br />8 DISP <br />LAUN�RYTRAY <br />CLOTHES WASHER <br />URINAL <br />JG FOUNTAIN <br />DRAIN <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC <br />f.ONi . PEf150N �ND PNONF. NO . . <br />CI� <br />SY���y�f ce7 <br />��f 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COHiiECT qLL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERN�NG THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN Ofi <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 qCW AND 296.200 WAC. <br />x�� a✓ 6�/9 <br />SIGN IUIIE OhT <br />LIiY BUSINE55 LICFNSG NO. <br />NO. � TYPE OF EOUIPMFl7T FEE <br />rvU—Iy/1ryuL1 <br />FORCED AIR 5' <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYI <br />WOOD STOVE <br />FIREPLACE <br />GAS <br />SUB TOTAL 5 � <br />PERMIT S <br />TOTAL FEE 3 � �-- <br />FOR OFFICE USE ONLY: <br />FPONT SEip�CK fiEAR SETBACR SIOE SETB�CR PIpN CIIECK NUMOEII <br />D D U /��) �j� <br />USE IONE LOi MEA V�CANL SIIF FEES <br />�� � ❑YES (7f No <br />— OUILOINC <br />HEIGIITLIMITATION NOOFOWELLING $REOFBIOGRI <br />3S' UNIfS <br />Ai� � PIUMpING <br />OCCUPANCY IKIO�SfOFIfS O!'CUPRNiIO�D DASEMENi <br />GR01JQ I � IAECIInNiCpl. <br />`li ❑YES NO <br />FlBE SPqINNLEfl REO'D <br />AJ D <br />FIRE AIA^qM, qE0'D <br />IV O <br />4� <br />RFA50.'1 ADDI IIONRI. Pt �N Cllf Ck <br />on�en <br />�iEASON <br />STn1E DOIIOMC. EIIf1C11n11GE <br />PLANSAr'�novennr CITYOFEVERETT ruonr,wonns <br />� LOCAL SALES <br />uA7E ll M_ i I�`� G TAX CODE IS 3105 7orA� <br />SUB TOTAL S <br />PEFMIT $ <br />TOTALFEE 5 <br />fkf�� � IfiEf.FIPINO <br />� /.," <br />