Laserfiche WebLink
L: � U <br /> APPLICATI�`�N FOR CONST�iUC'�:ON PERMIT <br /> '� CITY OF EVERETT• BUILDItJG DIVISION <br /> 3200 CEOAR STREET• EVERETT, WA 98201 • 259-Q810 <br /> O DEMOLITION ❑ COMBINATION CJ BUILDING ❑ MECHANICAL fl PLUMBING �l SIGN <br /> -'90JECT ADDRESS (� <br /> ."� ci ��� `I �L�;-Y �Sti 1.--� .,r , 1� '��L. <br /> ���Ep �(� K MAI RDORES$ s� ��n. � <br /> -UL 1 C `l A `i� � � Il,tl QI\ nt�i h I PHONe <br /> tr Vl tl � � n� �t Clt i <br /> ooRE55 GITv 21P �l PNONE <br /> Tl,'P�1tit.�r� Q �.�P1 t1 � „ � � u•- � ,l- /� � t � <br /> AGHIiCGTOR0E51GNER MqILADDRE55 y i � <br /> _ ��n z1P PNONE <br /> GENEflALCONTRA�TOq MAILp00RE55 ���y <br /> 21P PIIO4E STA1E VCENSE• <br /> U1vv��n C`i�-�-4- ��O"� l�?�� n, � , � ��an,�-� 0(1 L 1qS����� _ <br /> M CHANILALCONTRACTOR M�I�ADDRE55 ��n. <br /> ^� �-/ Z�P P110NE STA`i �ICENSE t ^ 'y- <br /> . . �{; SI�hT::�r:, Cif1.� ��.lc+� � �.' I� {'� (� l <br /> PLUMBINGCONTRACTOR MAILA RE55 � � � 1 •! �� � '^�� � �(`(�j^ S /` C���)C 1 �ei\�wCk� � /U 1 <br /> ��n Z�P PHONE STATE LICENSE r <br /> CO'�TRRCTPPIC O WO �yO <br /> ^• � HEATING SYSTEM: Cl GAS C_l ELECTRIC ❑ <br /> DESCRIBE WORK Ab0 SOUARE FOOTACE 1NVOWE� <br /> � '_� \ �•J ,(.. ., ' �,._,_� .:\ . WNTACTPERSOtjAN�PN0YEN0. �— <br /> 1 t i i - 1�7�L <br /> � ,�. , �� t , i. ,, <br /> "'`�a�"r" l,.:`f�t u:.�� . . ,�.�,;�ci`, • ' � <br /> '�1 (�t.: ..1. .,. ;�T, L. <br /> t-..� U.D.I' Ll1(;�. IC I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS I <br /> PA SED USE OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORqECT.ALL I <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGRLDESCflIPT10NOFPf10PEPTV(SMOWNBELOWOR�Tfq�N7W00001E5) WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �OT. THE GRANTING OF A PERMIT DGES NOT PRESUME TO GIVE <br /> ioi eiocK oc AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> , OTHER STATE OR IOCAL lAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2E0 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> P�RCELTAX I.O.NUM9EP CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN IENDER,FDDRESS.TELEPHONE NUNOER 5�E , r'�� /1 � , :y �- � `� - � `- <br /> OaTE <br /> CIN BUSMESS LICENSE N0. <br /> PLUMBINO MECHANICAL <br /> N�• TYPE OF FU(TURE OR ITEM FEE NO. TYPE OF FI%TURE OR ITEM <br /> I WATER CLOSE7(TOILET) FEE <br /> ' A/C—AMNDLGUNITS—H.P. , <br /> BATHTUB ; FORCED AIR SY�TEMS—B.T.U. M E A. <br /> i � <br /> ' LAVATOFY(WASH BASIN) � <br /> � HEAT PUMP • <br /> ' SHOW�!t � <br /> i <br /> UNIT HEATERS—B.T.U. M � <br /> �, KITCHEN SINK d DISP � CLOTHES DRYERS � <br /> DISHN'ASHER � � <br /> VENTILATION FAN � <br /> IAUNDRY TRAV ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � <br />� ' WOOD STOVE <br /> i <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) ' <br /> FLOOR DRAIN � <br /> — ' FIREPLACE INSERT(WOOD BURNING) � <br /> _ BACKFLOW PR�:VENTERS i GAS FIREPLACE � <br /> - SINK(SERVICE—BAR, ETC.) � GAS RANGE � <br /> .. ' GAS PIPING , <br /> � � EXHAUST FAN . <br /> � <br /> � <br /> i <br /> - � i <br /> � <br /> SUB TOTAL S ; SUB TOTAL S qn ; <br /> PERMIT 5 � PERMIT $ ��,— , <br /> TOTAL FEE S ' TOTAL FEE 5 - � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK qEARSETeACK SIOESETOACK P�hNCMECKNUM�EN <br /> FFE PECEIPTNO. <br /> 2� <br /> USEZONE LOTRPEA VqCqNiSITE FEES VALUATION FEE <br /> IlYES [I NO OUIl�INO <br /> '�RHTLIMITpT10N NO.OFOWELLINO SIZEOFOLOGRI, i <br /> UNIT$ <br /> PIUMeING i <br /> i <br /> OGC 1CY NO.OFSi0FIE5 OCCUPANTLOA7 BASEMENT <br /> --- MELHRNIC�I � <br /> OYES [7 NO <br /> FIREAURMflEO'� REASON ADDITONA�P�ANCHECN j <br /> FIPE SPRINNLEF REO'0 PEASON OTHER ' <br /> i <br /> STATE OUII�ING SURCNARGE � <br /> 7VVEOFCONSL P'�NSAPPPOVEDBY CITYOFEVERETT Pl1BUCWORRS ' <br /> LOCALSALES � <br /> OATE TAX CODE IS 3105 TOTAL ; <br />