Laserfiche WebLink
APPLICATIC 1 FOR CONSTRUCT_ JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT,WA 88201 •259-8810 <br /> ❑ DEMOUTION ❑ COMBINATION � BUILDING ❑ MECHANICAL O PIUMBING ❑ SIGN <br /> PROJECTADDRESS:�Q// � - (j,�/ocJ S�� S f' . <br /> R 4i11L�Dq1E55 Citt 21P PHONE <br /> �.�sr,�. ,3'//�J • 6.'sF/�cu .-Z!. S F E'�,��� i ' o. 9Yae� :s -��e sj3o�-��9y, <br /> 1EN11NT MIJl�Dp1E55 CITV 110 p�pqE <br /> .�>IC�. <br /> •RCINIECTOROESIGNER AWl11DORE55 Clrv ZI� PHONE <br /> � <br /> GENEMlGON1MCTOR MuIADOPE55 �iIY >�p R�ONE SGTEIICENSEr <br /> �J�CL�I.0 <br />� NECHAwCAlCON1MCTOR MNtADDRESS CI7V ZIP VIIONE STREUCENSE• <br /> %UMBM'GCONTMC70R MNIADORESS Citt ZIP pHONE StATEUCENSE� <br /> CONTMCT FIMCE OF VId11t <br /> � �,,, �-�;,,,, HEATING SYSTEM: ❑GAS ❑ELECTRIC �.✓a� <br /> OESCWlE SOU�REf TAGEINVOLVED CONTIICTPEHSON�NOPHONENO <br /> � X � � <br /> L-� � <br /> K- s� - ' m 3 -Y35 � <br /> � � � THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHEC7 ALL <br /> vaoros�o adr�c PROVISIONS OF lAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �.,��u'�afpNOFPiqPERtt(SIIOWNBEIdMOR11Tf/�CN1NqCOF1E5� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOY �4 �O �ppK �� pF _ AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION OH THE <br /> �o.�,�r�, PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTV TO PERFORM THE WORK FOH WMICH <br /> 5003- 60E'+ -�006 -p 06 APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> pM�CE/�Tp Lp.NUygEp CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> N CnC� <br /> CONSTRUCTIOH�OAN LENDER,�DDRE55.TElEP110NE NUMBER <br /> T E D�TE <br /> CITY BUSMESS IIGENSE NO. <br /> PLUMBING �£ � MECHANICAL <br /> NO. TVPE OF fl7fTUqE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNIT$ � <br /> BATHTUB � FORCED AIR SVSTEMS ' <br /> LAVATORY(WASH BASIN) HEAT PUMP �,— <br /> SHOWER � UNITHEATERS <br /> KITCHEN SINK 6 DISP i CLOTHES ORVERS <br /> DISHWASHER � RANGE HOOD <br /> UUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> � URINAL � MEfAL FIREPIACE(WOOD BURNING) <br /> DRINKINCa FOUNTAIN FIREPUICE INSERT(WOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE � <br /> BACKFLOW PREVENTERS i GAS RANGE <br /> SBJK(SERVICE—BAR,ETC.) GAS PIPING <br /> EXHAUSTFAN <br /> i <br /> i <br /> � <br /> SUB TOTAL f SUB TO?AL S <br /> PERMIT S i PERMIT E <br /> TOTAL FEE S � TOTAL FEE S <br /> FOR OFFICE USE ONLY: ,/ <br /> fPONTSETBACN ilEMSET�K � SIpES�r PlANC11EC1tNUMBER FEE �� ` �� RcCEIPiNO <br /> ,GL/ � � � <br /> �uSE IOTAREA veCenrSrtE FEE VALUAT�ON FEE <br /> ❑ves ❑ no eunowc (0 2D ' — <br /> MEIQNT l/MT�T1 p ra.a owewr�c S12E OF BLDGRI <br /> /J UNItS VtUMBMG � <br /> G- S F <br /> { <br /> OCCUP�NCV Np Of$fqtiES OCCUPANf LO�D B�SEMENT MECMnNICnL <br /> GRpIV �� <br /> �1 ❑VES lfMO <br /> FlFESVRINKLEflFEO'P HE�SON AOOILION�LPLAHC��FCN <br /> piXER <br /> FIIIEMARMREO'D AE�SpN ^ <br /> ST�TE BUIIDMC SIIRCHnIiCE — i /�/1 <br /> ^CS� <br /> 1VVEOFf,ON51 PL4NS�PPPOVEDBY GTYOFEVERETT PUBIIf.WORKS '�� <br /> —� �J ��" LOCALSALES <br /> o�r6 3il !e TAX CODE IS 3105 TOTAL �Q I '�� <br />