Laserfiche WebLink
APPLICAT14�1 FQR CONSTRUCI �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br /> 1l DEMOLITION Il COMBINATiON ❑ BUILDING Cl MECHANICAL ��PLUMBING I-1 SIGN <br /> PROJECT ADDRESS �!r � <br /> /D� ,Uc'K� �G/7 �'L <br /> OWNER MAILA�DRESS CITY ZIP ^ PIIONFy' <br /> '� � �� i� �� �! L� //e''� �r!� <br /> �VY1a/� ����0 /D� 11�- yi7�n , � �Uu�= l��0 7 -0 �::- <br /> TENANT ^ MAlI.A0DRE55 CITY ZIP PHONE <br /> �,L//{��j' -G �c� u>'+G 1/1�% <br /> PFCHIT�ECTOF�❑ESI3 MAILAOOf7E55 CITV ZIP ' PHONE � <br /> GENFRAL CONTPACTOR MAILAU�RESS CITY ZIP PHONE STATE LIGENSE n <br /> ♦ <br /> MEC�CONTRACTOR MAILAD�RESS CIN ZIP PHONE STATE UCENSE M <br /> PLUMBINCaCONTRACTOR MAILAOORE55 CITY ZIP PHONF STAiELICENSE/ <br /> WNTRACTP CEOF WORK HEATING SYSTEh1: �GAS ❑ ELECTRIC ❑ <br /> � ys�� <br /> DESCRIBE WORK AND S�l1ARE FOOTAGE INVOLVE= CONTACT PEFSON AND I'fiONE NO. <br /> , / - -� ot " LGI % o <br /> G�s rh�x�e �sis'i� f c �,y,�``, <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSEO USE OF BIIILOING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � <br /> WORK WILL BE COMPLIED WITH WHETHER SPEC�FIED HEREIN OR <br /> LEGAL�ESCRIPTIONOFPFOPERNISHOWNBELOWOPATfAC1iTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGI�LAiING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORh FOR WHICH <br /> AFPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%I.D.NUMBER CONT�ACTORS LAW 1827 RCW AND 2�J6200 WAC. <br /> /f � <br /> CONSiRUCTION LOAN LENUER.AOURE55,TELEPHONE NUMBEfl x/���'�[����"� �` / Iv���N " �_/� , <br /> $IGNATUFE v OATE <br /> GIN BUSINE55 LICENSE NO. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER GLOSET(TOILET) � A/C—A/HNDLG IJNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK&DISP i CLOTHES DRYERS ' <br /> � �ISHWASHER � VtNTILATION FAN � <br /> LAUNDRV TRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> � WOOD STOVE � <br /> URINAL � <br /> ' METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN ' <br /> � FIREPLACE INSERT(WOOD BURNING) ' <br /> FLOOR DRAIN i <br /> BACKFLOW PREVENTERS ; GASFIREPIACE � <br /> SINK(SERVICE—BAR.ETC.) � GAS RANGE ' <br /> � GAS PIPING � <br /> � � <br /> � EXHAUST FAN ' .— <br /> - � <br /> i � <br /> i <br /> � � <br /> SUB TOTAL 5 ; SUB TOTAL S � <br /> PERMIT S i PERMIT S � <br /> TOTAIFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SEIDACK REM1Fl SFTOACK SI�E SEiBACN PV.N CNECK qM1tOE^R FEE RrCEIPT h0. <br /> �V/ <br /> USE20NE �oranEn VPCANTSITE FEES VALUATION FEE <br /> i <br /> i <br /> f7YE5 C1 NO BUILOING � <br /> HEIGMT IIMITATION N0.UF OWELLING SIZE OF 9LDGR1. � <br /> i <br /> UNIT$ PLUM�ING <br /> � <br /> OCCUPANCY NOAFSTORIES OCCUPANTLOAO BPSEMENT MECHANICAL � <br /> i <br /> GROl1F' � <br /> ❑YES fl NO � <br /> AUDITIONFI PLAN CHECK � <br /> FIREALAFMREO'D RFASON —� <br /> i <br /> OTIIER � <br /> i <br /> FIRE SPRINKLER REO'0 AEASON � <br /> STATE�111L01NG SURCII�RGE � <br /> � <br /> TVPEOFCONST. P�NSAPPROVEDUV CITYOFEVERETT P��LICWORKS y_ <br /> LOCAL SALES � <br /> oATE TAX CODE IS 3105 TOTAL ' <br />