Laserfiche WebLink
APPLICATIvr�l FOR CONSTRUCl �ON PERMlT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 32D0 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> rl DEMOLITION f 1 COMBINATION f i BUILDING I 1 MECHANICAL f V� PWMBING fl SIGN <br /> PROJECT ADDRESS 9,� �� ` <br /> � �bl�5�/ �v�' L UL'�'C �,t�� <br /> OWNER �,M�ILhROURE55 ^ �ITY pm PNONE '/ <br /> V1U�./ L1.1l- }'l/� IQ7k �11�C/ CC /�/ ! �r��0� o?�� Y'35�`' <br /> T[N� / M�I�IppqE55 CITY zlp try�pNE <br /> �a //l�rr/'lin / <br /> Ad w:iTiCi GR�ES�GN[R MAII GD����ry'`�p GITy Zip ���E -- - <br /> ✓(/ <br /> GEN[RALCONTpA�TOR MAILIWRE55 �liv DP W1pNE STATEIIL[NSE� <br /> IdECM�NILQ CONiR�CTOR M61L FDDRE55 GTY IIF PHONE ST�TE IICGNSE� <br /> �P�s `r-�/�ry,B;Ne �oa A�e i S �va � �a90 s � a� a e-� a r i �3 8 D <br /> PLUMBMIGGONTPRf,TOF M�ItADDRESS CITY ZIP PHONE $TAlE iCENSE• <br /> GONTRACT PP�CE OF YRX�N <br /> HEATING SYSTEM: f 1 GAS �1 ELECTRIC �l <br /> DESCRIBE M/OHI(AND SOUARE CJO7AGE INYOLVED CONTRCi PF RSONANO PHpNE NO <br /> � I HEREBY CERTIFY THAT I HavE REAO AND EXAMINED 7HIS <br /> i'RONSEDUSEOFBUIL�INO APPLICATION AND KNOW THE SAMF TO OE TRUE AND CORFECT ALL <br /> PROYISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHEF SPECIFIED HEREIN OR <br /> IEGILLDESCRIPTIONOfPROPERIY(SHOWNBEIOWOR�RRCNTWOCOPIESI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCN or AUTHORITY TO VIOLATE OR CANCEI. THE PROVISION OF ANY <br /> OTHER STATE OR LOCAI LAW�EGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERtV TO PERFORM THE WORK FOR WHICH <br /> APPLICATIOtJ IS MADE AND I COMPLY WITH THE STATE <br /> P�RCELT�VI I.D.NUM9ER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTRUGTIONIO�NLENOER,A�ORE55.T[IEPNpNE NUMBER x <br /> SIGNAfURE ORT[ <br /> CIfY BUSINF.SS LICENSC NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlKTURE OR I?EM fEE NO. TVPE OF EQUIPMENT FEE <br /> WA7ERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. T— <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � � <br /> LAVATORY(WASH BASIN) i HEAT PUMP —i— <br /> SHOWER � UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � VENTILATIOIJ FAN <br /> LAUNDRY TRAV � RANGE HOOD ' <br /> CLOTHES WASHER � ( WATER HEF,TER i <br /> URINAL WOOD STOVE � <br /> DRINKING FOUNTAIN METAL FIREPLACE(WOOD�URNING) i <br /> / FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE ' <br /> SINK(SERVICE—DAR, ETC.) GAS RANGE ' <br /> P �, n'�<; GAS PIPING ' <br /> / � j�/// i EXHAUST FAN � <br /> / e.CT iYtAC � � <br /> I � 'N; ; ; <br /> $UB TOTAL S ' SUB TOTAL $ '�'j <br /> PEFMIT $ � PERMIT $ i <br /> TOTALFEE S � TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> �NONi SFTPACN R[AtI SfT6RCN SIOE SETBAf.R PI AN OILCK NUMff[q / f[F PfCHP1 N0. <br /> u ���-�h <br /> usetor+e iorane� VAGANT51lF PEES VALUATION FEE <br /> I I VES f 1 NO p�ILDMG � <br /> i <br /> NEIGHiLIMITATION NOOFUWELUNp SIIEOFBIW�I � <br /> UNiTg <br /> PUIM9ING 7 i <br /> OCCUPANCY NO 0[SIDFilS OCCUPANTLORD BASEMENT � <br /> GROUP M[CMAMCRL 7: <br /> I IYES I1 NO — i — <br /> I"IpEAUFMREOD RFASpN AODtlIUNPI.i`tANCNF.CK i <br /> 01HEA � <br /> fIRFSPqINRIFRRE00 RF�S(NJ <br /> � <br /> ti�Al[OIIRpR1(i SIIRCHAqCE i <br /> i <br /> rvreorr,or+ST �tnNsarraoveoer CITYOFEVEiiETT runiir.wonks <br /> LOCAL SALES '-- <br /> nATF TAX CODE IS 3105 TOTAL 1 — <br />