Laserfiche WebLink
APPLICATIC�! FOR CONSTRUCI .ON PEi;IWIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEQAR STRFET• EVEREIT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: <br />( q MAIL�DORE55 CItt I�P VNpNE <br /> �A � Nrtil(;YCF��EPC`�^.�. o!Tvt���.�� ��� �/q�2G� �jti � � <br /> 1ANl�DDH[SS GlY }�P P�qNE <br /> I � <br /> MCNTEGTdi0E5K.NCR�� MAIIMpiE55 G�n' iiP fNONE <br /> �p�y�qry���Tpq MIJIADDRE55 CiIY ZIP 1 PHONE 51RLlICENSE• <br /> � ���Ta.�T� �I�—r�w Z&�t� ����� "� ��1_`( 1� ���r�)Nl�K� <br /> HpNE GTATE L FNSE• <br /> � � 7i5J' 'v" � <br /> p�����Tp/�C}pq MI111A00NE55 CIfV ZIP PIqNE $TALELIGENSE� <br /> °°"T""°T°"'c�aw«"` �' -� HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> pE5�,T1�E Mqfilc�ND SOUARE FOOTwiE INVOIVED CONT.V;T PERSON AN�i'NDNE HO <br /> f. l�'�� l�rJ�t;= — <br /> ,. <br /> — � , � i� � 7i �Q - <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> vnovoseouse ov ain�dna PROViSIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH V�HETHER SPECIFIED HEREIN OR <br /> ��pES�q�p7�p�pPqq{'ERTY(51qWHBELOWORA1ThCHTWOCOPIES) NOT. THE GRANTING OF A PERMII' DOES NOT PRESUME TO GIVE <br /> L� ��K � AUTHORITY �O VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOHMANCE OF GONSTRUCTION.THAT I AM AUTHORIZFD BY THE <br /> , OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICAl10N IS D COMPLY WITH THE STATE <br /> CONTRACTOR AW 1 . ND 96.200 WAC. <br /> F�RCELT/Jl1A.NUMlER�'/� I � �'I� I��I � � , II <br /> �/1 <br /> 1 <br /> (',p�$iNUCTIdI IONI lENOEN.M1IN1E55.TElER10HE MI�ABER �( <br /> SIGNQURE �AT-� <br /> CITY BVSMESS IIGGNSC NO <br /> ��6 MECHANICAL <br /> ►q, TYPE OF Fl7(TURE OR ITEM FEE NO. 7YPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILE'') � A/C—A/HNDLG UNITS : <br /> BATHTUB ' fORCED AIR SYSTEMS � ' <br /> LAVATORV(Wl.SH BASIPI) � HEAT PUMP ' . <br /> SHOWER � UNIT HEATERS � <br /> KITCHEN SINK 6 DISP � CLOTHES DRYEPS � <br /> DISHWASNER � RANGE HOOD ' <br /> UUNDRY TRAY ; WATEH HEATER � <br /> CIOTHES WASHER � WOODSTOVE ' <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINMING FOUNTAIN FIREPIACE INSERT(WOOD BURNING) � <br /> FlOOR ORAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS FIANGE � <br /> SINK(SERVICE—BAH,ETC.) GAS PIPING ' <br /> EXHAUST FAN � <br /> — _—_ __ <br /> i ---+� <br /> � <br /> SUB TUTAL S � SUB TOTAI E i <br /> PEiiM1T f i PERMIT E � <br /> TOTALFEE S ' TOTALFEE E <br /> FOR OFFlCE USE ONLY: - <br /> (RONT SETP�LK PE�P SETBACN SIDE SETB�CM PL�N C11[CR NUM�Ff1 fEf REf.Pt'1 NO <br /> �:3S�o� <br /> useiq+e IOTAFEA �ACANTSRE FEES VALUATION FEE <br /> ❑YES ❑� ONlO1NC � <br /> � <br /> HEIf•IIT LIMIUTION NO OF OWELLING $CE OF BIDG�� <br /> UNIIS t`111V01NG � <br /> T <br /> _ 1 <br /> OCGUPANCY MO(%SIMi6 OCCUPANiIO�D B�SEMENi MCCN4NIL�L � <br /> GRWP — _—_ <br /> ❑VES ❑NO <br /> GD�IIIONM^'�NfnFCN <br /> FIRESPRIKKLERREO'U �fA50N � <br /> O�NE� <br /> FlREAWiMNEO'L REAS(N1 <br /> STA1E OU�IDING$���CN�qGE <br /> trreo�covsr v�nr+5�rrnovEner CITYOFEVERETT n��p����pKs _ <br /> LOCAL SALES — <br /> o�tE TAX CODE IS 3105 TO7AL _ <br />