Laserfiche WebLink
APPLICATIC`l FOR CONSTRUCT �JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 EDAR STREET•EVERETT, WA 98201 •259-8810 <br /> �/ G�n��. ►�"���N�,c�n. <br /> ' ❑ D�OLITfON� / ❑ COMBINA ION ❑ BUILDIN ❑ MECHANICAL ❑ PLUMBING O SIGN <br /> PROJECT ADDRESS:_� /CL�•� r <br /> OVME t1�0011E Urv i�r rNONE <br /> 2 <br /> 7EN NT M111 5 CII• l�P PNOHE <br /> � <br /> � HII� t Gi DESIGNEf/ yyI�ODRES -/�'I` ,f�T� 5��7i� �NONE <br /> i• �rc , i J ii i <br /> / �.i r� /v � .ii i.. <br /> �a�rn.e'r - =-�_�—af` <br /> GENEMLGONTR CfIX1 OORE55 Glr �A/. I�^iP .J� ���/�PiIUNE Si��EIICEN E� <br /> /���( LC-1 1 ,� "' <br /> MECN�IAfj ICONTR�LTOR M�I ADDRE55 /' f.iiv p Im / P�� STAfE IICF.NSE� <br /> 11Gw�oG-t � �n����t� (�ln:� � ���J Sl.J ISJ�` /(r� <br /> PLUYBIN CONTR(!1 M I�,DDNESS n/� J C�n' TIP PNONE S1�TEUCENSE� <br /> r� s • p L /OSG1Z _ <br /> CONfRACT PPoCE Of WOIIK EATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> / �� ^ <br /> pQS�RIBEY/OR NpSOUAREF TA6 OIVED I�CIPC SONNIO NO ^' � _ <br /> vi i✓� <br /> J(l�.dL—. <br /> l � <br /> � t HEREBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS <br /> PLICATION AND KNOW THE SAME TO BE TRl1E AND CORRECT ALL <br /> v se se or �n� a PROVISIONS OF LAWS AND ORDINANCES 60VERNING THIS TYPE OF <br /> ' WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lEOALDE mvTi ovrno�nnls��++ee�owan� NTWOCOPIE51 NOT. THE 6RANTINO OF A PERMIT DOES NOT PHESUME TO GIVE <br /> �pr eiocK oo AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6ULATINO CONSTRUCTION OR THE <br /> � • z PE ORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV iHE <br /> O _ ! O�Eq OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> ��{" CPTION IS MADE AND 1 COMPLV WITH THE STATE <br /> PNICELTIUIID. BER NTR CTORBt 10.27 HCW AND 296200 WAC. <br /> -� <br /> CONSTRUG110NlO�HLENDER./�WRE55 TELEP110NEM1MOER <br /> SIU UR D�IE <br /> CITYBU SSLIGENSENO <br /> PLUMBINO MECH NICAI <br /> NO. TYPE OF FUfTUPE OR ITEM FEE NO. TYPE Of ECUIPMENT FEE <br /> WATER CIOSET�TOILET) � NC—A/HNDIG UNITS ' <br /> BATHTUB ; FORCED AIR SYSTEMS i <br /> UIVATORY(WASN BASIN) � HEAT PUMP � <br /> SHOWER � UNIT I IEATEHS <br /> KITCHEN SINK 8 DISP i CLOTHES ORVERS _�_ <br /> DISHWASHER RANGE HOOD ' <br /> UIUNDRY TRAY � WATEfi HEATEP i <br /> CLOTHES WASHER � WOOD STOVE <br /> ME1AL FIFlEPIACE(WOOD BURNING) �; <br /> URINAL , <br /> DRINKINO FOUNTAIN FIREPLACE INSERT(WOOD BURNING) � <br /> FLOOR ORAIN � GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GAS RANGE � <br /> SINK(SERVICE—BAR,ETC.) CAS PIPING ' <br /> FXHAUST FAN <br /> � <br /> � ' <br /> i ; <br /> � T <br /> 1 <br /> SUB TOTAL f ' SUB TOTAL f � <br /> PERMIT f � PERMIT S � <br /> TOTALFEE S � TOTAIFEE f ' <br /> FOR OFI�ICE USE ONLV: <br /> iRdlTSfTPACR �EMISFTB�CN S�DESEIB�CK �I�N�IICCKHUA�11Pn fFF ' �Ef.f��INO <br /> UiE10NE im�nc� wceH�srte F ES VAIUATION FEE <br /> i <br /> ❑YEL ❑ NU pt➢IDWf• �' �� � i 17� <br /> HE�4NTU41UTION MOOfOWEU�IIG 512EO�BlWR1 T' � <br /> UN�IC .� i) 1 // riuunwa _�__ <br /> T/ � <br /> a GUFANCY NOMSIMES OCCUP�NIl0�0 BASEMENt MEOUN�C�I _ _ _ <br /> i <br /> I� ❑r[s kC�n � <br /> MRESPRINNLEwIHwR'EO'D RE�C(k! �ODiIiONM�1�NC�IfGK <br /> ��_ <br /> /v_ 1 <br /> OLIE11 <br /> FIRENMMR� �E��OH — <br /> 51A1[flU1lDIN(i SIIfiC14f1f•C �'� <br /> �1� ` <br /> rmcorr,or�st ninNs�rrnovrner CITYOFEVERETT �•umir.wtmKs ' <br /> � �W�j LOCAL SAIES ----�— - —��— <br /> �„�E 7 TAX CODE IS J105 TO7AL __ ,J �.'�_I �_i_�_) <br />