Laserfiche WebLink
,� _ <br /> A1PP�.ICATIO�r1 FOR CONSTRUCT�dN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 9t�201 •259-8810 <br /> fl DEMOLITION fl COMBINATION fl BUILDING f-] MECHANICAI �l PLUMBING I-1 SIGN <br /> PROJECT ADDRESS <br /> " e_c' I <br /> ONMER NI11L�DOiiE55 CITY 21P PMONE <br /> '��r �- M�^;_ Fr o.�, k �C' -„Z�b'- 3�/S� <br /> IEN�NT MRILADDRE55 CITY 21P PHONE <br /> RRCHITECTORDESIGNER MRILAOORES$ GITv lIP PHONE <br /> GEN@RpICONiMCiqi MAll�0�PE55 (;ILV 21P p110N[ STAIELIC[NSE� <br /> MECH�NICALCDNTRALTOR MAILAD1DRE55 I / CITY ZIC PHONE STAiF.UCENSE� <br /> 7�J C<7✓I t'_ � �.r�u �� I f �/ 1�! U N�1 �/rHo �r�r �� (7� "F( r ly iGC�-�,Sr3`�)�� rJL��NrI l�OC</i) l <br /> PLUMBINGCONiRRCTOR MAILAUORE CIJ#;��q�,� S V� 1�` C`1� PHONE STAiELiCENSE� <br /> /" <br /> �Q � 7 ) <br /> GONT ACT PRICE OF YNRK <br /> HEATING SYSTEM: �GAS rl ELECTRIC fl <br /> DESCRIBE WORK ANO$ ARE FOOTAGE IN)�VED � CONTACT PERSON RND P110NE 0 /��'{ /� <br /> � �"c � IA � . �� (�]n`���(l <br /> 3c� ` / �I ��'"'� �y I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Q w I.aJA�'�CC VI Qn,T f�' I� 5MC c � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PNOPOSE�USE F BUILDIN � ° 7' `"e- pROVI510NC OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � <br /> � ��+ WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OA <br /> IEGAIDE$CR�PtIIXJpFPROPER 1sHownaeiowor� nacr�Two omesl NOL THE GFANTING OF A PERMIT DOES NOT PPESUME TO GIVE <br /> �ot e�ocK or AUTHOR�TY TO VIOLATE Ofl CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOPMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �ARCELTAX ID.NUMBER CONTRACTORS lAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LO�N LENDER,ADORESS.TEIEPNONE NUMBER CZSL� `_ <br /> SIGN� i� /1[ 7_ � <br /> CITY BUSMESS UCENSC NO. <br /> PLUMBING MECHANICAL <br /> NO. TWE OF FlXTURE OR ITEM FEE NO. 7VPE OF ECUIPMENT FEE <br /> � WATER CLOSET(TOILET) FVC—AMNDLG UNITS—H.P. � <br /> BATHTUB � FORCED AIR SYSTCMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK h DISP ; CLOTHES DRVERS � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE FIOOD ; <br /> CLOTHES WASHER � WATER HEATER <br /> � <br /> URINAI ' WOOD STOVE ; <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) � <br /> —,— <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTEfiS � � GAS FIREPLACE [o�, ; <br /> SINK(SERVIGE—BAR,ETC.) � GAS RANGE <br /> GAS PIPING <br /> i E%HAUSTFAN i <br /> i i <br /> SUB TOTAL $ ; SUB TOTAL $ ;— <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE $ � TOTALFEE S ' <br /> FOR OFFICE U5E ONLY: <br /> FRONT SETPAGK RERfI SFTBALN SI�E SETBACK PLAN C11ECN NUMBEP F[E AEf.FIPT NO. <br /> USE20NE iotanen VRCANISIIE FEES VALUATION FEE <br /> IIYES f1 NO OUILOING � <br /> � <br /> HEIGIIT L�MITATION NO OF DWELLING SILE OF OLDG�f.I � <br /> UN175 PlUMOiNG i <br /> � <br /> �DUPANCV NO O�StOmES OCCUPP:JTIOA� BASEMENT MECIIRNiC�L � <br /> I1vE5 fl NO — � <br /> FIRE�LAPM REOD RFA'i0N AOO1110NAI.PLnN LNf.CN � <br /> � <br /> O7HEf1 � <br /> FlRESPPINNLERREO'0 RF�SCY � <br /> STAIE OUIIDING SURCMARGE � <br /> rrveoFr,oNST cinNsamnoveoav CITYOFEVERETT rum.ir,wonKs 1 <br /> LOCAL SALES <br /> uATE TAX CODE IS 3105 TOTAL ; <br />