Laserfiche WebLink
APPLICATIG ; FOR CONSTRUCT�JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•BB10 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: ���r)� � �if(�� n� �� C1�C �'�'77- CI���c�D <br /> ONMER Nu1�0011F55 LI1Y Ii PNONE <br /> c:�✓z«�i� �Yl��n m�c :?r n� Cc�ifC CAnlr� �f(G�o U�o - ���`� � <br /> 7EN�N1 ��u�i^UnbOnf55 C11Y )m P��ONE �— T� <br /> ' A VY1 � <br /> MIp11TCCiORpE51GNEN M�R�ODf1E55 LitY )iP PNONE <br /> OE�lEII�CONifI CTqI M il�OD11E55 ilY )m PI�ONE Sf�TEUCFNSE� <br /> �1 ,a �=,e l-�t�-�= ,� � Ac�n�,e �IJk� �r� ���9��/,�,��;���;�� <br /> A1ECH�InCµLONTReC10n M�It AOOP 55 f.�tY )m 1 N ST�TE ULENSF� <br /> �,.,�nn'�- �?��� - ��� <br /> PIU�AlMIOCONiR�GTpI MMI.�pDi1E55 LIfY 21P ` PI NE SUTEIICENSE� <br /> cor/riucrrnicEorwon � HEATINGSYSTEM: GAS OELECTHIC ❑ <br /> OESd1llE N011K 11ND SOU�RE f00TA6E wVOtVEO CONI�Ci PCfI50H ANO FNONE NO <br /> \ 1 � <br /> C�Z."� u <br /> I f/EREOY CERTIFY THAT I HAVE HEAD AND EXAMINEU THIS <br /> - APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> vnoros[ousea euiara PROVISIONS OF LAWS AND OFDINANCES GOVERNtNG THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WMETHER SPECIFIED HEREIN OR <br /> 1E011L0ESC/pPT10NOFP110PERTYI$IqNNBElOWp1�TTACNTWOCpPlES) NOT. THE ORANTINCi OF A PERMIT DOES NOT PRESUME TO OIVE <br /> ior_ e�ocK a AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OF LOCAL LAW REODUTINO CONSTRUCiION OR THE <br /> PERFORMANCE Of CONSTRUCTION.TNAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORN FOR WHICH <br /> APPLICATION I, DE COMPLY WITH THE ST.�TE <br /> MIICElT/J11.D.MIMEER CONTRACTO AWIB. AN 296200WAC. <br /> .�i ��-� ��Ol��l1(a � � <br /> CONSTiIUCTIONLOu1lENDER. E54.IELEPNONENUMlE11 x � <br /> SION�TURE � 11TE <br /> QTY BUSINESS IICENSE NO <br /> PLUTAS�NO MECHANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FE[ NO. ?YPE Of EGUIPMENT FEE <br /> WATER CLOSET(TOILE� � A/C—AMNDLO UNITS � <br /> BATHTUB ; FORCEDAIRSVSTEMS ' . <br /> LAVATORV(WASH BASIN) —T HEAT PUMP i <br /> SHOWER � UNITNEATERS � <br /> KITCHEN SINK 8 DISP i CLOTHES DRVERS ' <br /> � <br /> DISHWASHER � RANGE HOOD � <br /> UUNDRV TRAY � WATER HEATER ' <br /> CIOTHES WASHER i WOOD STOVE r <br /> URINAL � MEfAL FIREPLACE(WOOD BURN�N6) � <br /> DRINKINO FOUNTAIN i FIREPLACE 14SERT(WOOD BURNINO) ; <br /> FLOOR ORAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GASRANGE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING —T <br /> EXHAUST FAN � <br /> � <br /> � � <br /> SUB TOTAL f ' SUB TOTA� S � ' <br /> PERMIT f � PERMIT S � <br /> TOTAL FEE f � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> ifqNTSETB�CK PE�115ETB1CM SIDESETB�Ck PUNCIIECNNUMOffI fEF REf.EIPiNO <br /> usExart iot�n¢e vsc•r�rsne FEES WLUAT�ON FEE <br /> ❑res ❑ No owinwa I <br /> � <br /> NEI6NTUMII�TION NOOSOWfllINO SIIEO�BLDORI <br /> UMtS P�UMOiN6 i <br /> OCC��MCv Iq d S�MFS OCCUP�Nf�O�D lASEMENT ! <br /> OR �IFC,II�HICAI � <br /> ❑YES ❑ NQ � — <br /> I <br /> FIRE6PRIMQERREOV �EASON �DDIII�N4PUNCnfGM � <br /> Ob1En � <br /> i <br /> �INEMARMPEO'0 RF�SfM� � <br /> Sf�tE OIIROWO SIIt1GU11(•� � <br /> _' �_ <br /> trv¢orr.owsr ruNs�rnnov¢oer CITYOFEVEREIT nunnr.wonKS _ <br /> LOCAL SALES — — --'— <br /> o.rt TAIf CODE IS 9105 TOTaL <br />