Laserfiche WebLink
APPLICATIl.�� FOR CONSTRUC7 ON PIf�MIT <br /> CITY OF EVERETT•BUIIDING DIVISION � <br /> 3200 CEDAR STREEY•EVERETT, WA 98201 •259-8810 <br /> � �EYOl�T10N ❑ COMBINATION �BUILDINO ❑ MECMi�NICAI ❑ PLUMBIN(i ❑ SNiN <br /> �CT ADOREBS: <br /> � � CT ��c-rr r�l� �v�t-/�� <br /> mu��oa�ss urr zir y� p� <br /> .c��, C� ►��.g�.��..,���z.��S,�a,�a+� IMaw.s���� i �A ���nlJ G,43 3�Zo - <br /> ��'�^"'��� CITY � � jIV �� p " <br /> YCN�ECi0110E51CaNFR YY1110D11E55 GITY ZIP p��p� <br /> F`a+F�_Ase:�._,4rm uc a,a.�c ne,_.y�u b� ��1Y3�,S�"_30t�n C4ak1 43i-avs,rf <br /> �����r� �����'` —7 cirv nr P�qNE ilATELICENSEI <br /> �c��m�ct�on�,T�oo��12415 �`� ��,.,+•,�,f5l1� 4Y2� �iL�.�c' = o F�ecF�N��om � <br /> �� ��y) � r 21P V ST�TE LIGENSf� <br /> CI�Qpyf�TL�� RV �bQ *�L� �G. /wLT3 �ZL1�i� 4�—�� �u���Q� <br /> A����� /\��i� ����� y. Gtt 11P PIIpNE ST�TELICENSE� <br /> fL1A.11�11��L lYir4�= � �x�J- Q,`.� Mlr v`. O <br /> OONIMC7 PIiCE Oi WOIIR �i <br /> 7 HEATING SYSTEM: GAS ❑E�ECTRIC ❑ <br /> sc�won�wo sw��roo��wvaveo CONT�CT VENSON M!D P1AlNE <br /> ' m S - } <br /> I HEREBV CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> ppp�p�a�prp APPLICATION AND KNOW THE SAME TO BE TRUE AND CORpECT ALL <br /> PROVIS1pNS OF UWS AND OROINANCES GOVERNING TINS TYPE OF <br /> �[�woEs�miwasrnoc�mvlS�aF�OwOn�n�cNnvoCov�s1 �� W��� � ����ED WITH WHETHER SPECIFIEO HEREIN OR <br /> NOT. 1HE 6RANTINfi pF A PERMIT DOES NOT PRESUME TO (31VE <br /> �oT �3 etOac OF AUTHORITV TO VIOLATE OR CANCEL THE PfiOVIS10N OF ANV <br /> OTHER STATE OR LOCAL UW REGUUTINB(bNSTfiUCT1pN Oq TME <br /> PERFOHMANCE OF CONSTRUCTION.THAT I AM AUTIppRED BV TME <br /> ONMIER OF THIS PROPERTV TO PERFORM THE WppK Fpp yyH1�1q <br /> APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> wwc[i wi ia Mre¢n CONTRACT UW 1827 RCW AND 29820p WqC. I / <br /> WMBIPIIC710NlWNlENOER.A0d1E55.iELERId4M11lER JUf� �. / T �! <br /> � ^SN_i1N RE \O <br /> �-�0'V � �+T� � /�? ��t� <br /> G 55 LICENSE NO <br /> K�b AAEq1ApICAL <br /> N0. TYPE OF RIRIME OR REY FEE iW. TYPE OF EOtIIPM[i1T FEE <br /> WATER Cl0$ET(TqLEn /� , �_�Q� � <br /> �TM� � ; FORCEDAIRSVSTEMS � <br /> "� IAVATORY(WASH BASIN)// � HEAT PUMP � <br /> �R I ' UNIT HEATERS � <br /> KRGiEN SMi1C 8 dSP ; CLOTHES ORVERS <br /> a��p � RANGE FIOOD � <br /> LAUNDRV TRAV � WATER HEATER . � <br /> CIOTHESWASNER � WOODSTOVE , <br /> ��� MEfAL FIREPLACE(WOOD BURNING) � <br /> DRNiCING FOUJTAIN � FlREPLqCE INSEFif(YVOOD BURNIN6) � <br /> ����NN GAS flREPLACE <br /> BACKROW PREVENTEqS ; GAS RANGE � <br /> SM'MC(SEiN10E—BAR.ETC.) CaAS PIPMG / <br /> __ FXFIHUST FAN <br /> r � <br /> � � <br /> � <br /> � <br /> SU8 TOTAL f SUB TOTAL t � <br /> PER\NT f � PERMIT S <br /> TOTALfEE i � TOTALFEE f � <br /> FOR OFFlCE USE ONLY: � /3 <br /> �,.20 � ��,�,�� � �o� t �,�„���«�� FEF a� ���.� <br /> � <br /> unEzorE iorw�• v�c�wT FEES VALUATON FEE <br /> �'� � ��' or[5 ❑ra euia�xs <br /> �a�n u�n � ra av owcun«s suE a � �C�lo � O <br /> uwrs �b I�F�.K.G�utCa auraeiNa � � <br /> o��cv ru a sra.�s occw�wr iow s�u�Hr �cM��� � <br /> 3 �•i Z ❑.es �o CJ; OcJ <br /> RIE 9PItlN10.FP REO'D r�.sori •oaTroN•i tt�r.c�c« ; /d- <br /> OTNER <br /> FNENAIMREO'D RE�.4d/ <br /> ST�TE BUIL01�SIIRCHMiGE �T <br /> Ci <br /> rroE or r.wst runs o er CITY Oi EVERE7T %�ai.ir,woa�cs � <br /> �I:I` LOCAL SALES - � '�� <br /> -i� D�TE ZZ 9(o TAX CODE IS 3705 TOTM. ; � <br />