Laserfiche WebLink
� <br /> /�PPLICATII..� FQR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISiON <br /> 3200 CEDAR STREET• EVERETT, WA 98201 259-8810 <br /> ❑ DEMOLI710N ❑ COMBINATION f7 BUILDING � MECHANICAL ❑ pLUM81NG Cl SIGN <br /> PROJECT ADDRES; 927 <br /> � C U��c��� v� k�a�/ tlii�<� ��. <br /> � 7 iJ�t mrn�i�-�A��ES���G /D�� /Uf� Z-SlD/� ..��LN�9,�00�/ �.�032� <br /> IENAM MAILAODFE55 Lli! ZIP PHONE <br /> 9- Q <br /> AR ECT OR OESIGNER MAIL RE55 CITY IP PHONE <br /> GENERALCON7qFCTOR MAILAOOfiE55 CITY 21P PHONE STATELICENSE/ <br /> MECHANICALCONTRACiOR MAILADDRE55 CIN ZIP PHON aO� `'j�(�'/ TELICENSEi <br /> r�;�-ti F;�, .5✓s�cros �/�i��, -��/� A�.. r'. T�.��M.� i,�A. �i�ad S�T,�fs�3�ai <br /> PUlM91NGC NTRACTOR MAIL�AO�RE55 CITY ZIP PHONE STATELICENSE� <br /> CONTRACTPPICE OF WOAK <br /> ,�I.SG 6 9�" HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> DESCflIBE`.NORN ANO SOUFFE F�9TAGE INVOLVED CONTACT PERSON ANO PHONE N0. /��) <br /> � � 1 l ,f f G d� � � [� <br /> I HEREBY CERTIFY THAT I HAVF. READ AND EXAMINED THIS <br /> PRCPOSEO USE OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE ANf:CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFfED HEREIN OR <br /> LEGALDESCRIPTIONCFPfiOPERN�SHOWN�ELOIYORATfPCHTWOCOPIES� NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> ioT__e�ocK oF AUTHORITY TO VIOLATE OR CANCEL TFIE PROVISION OF ANY <br /> j / OTHER STATE OR LOCAL LAW PEGULATIP!:i CONSTRUCTION OR THE <br /> j (� � PERFORMANCE OF CONSTRUGTION.THAT I AM AUTHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH <br /> % APPLICATION IS MADE P.ND I COMF'LY WITH THE STATE <br /> anace�inx i.o. Nrneea �- ' CONTRACTORS LAW 18.27 flCW AND 296.200 WAC. <br /> CONSTRUC ON LOAN LE 2ifAU0RE55,TE�E�°HONE NUMBEP X �— - �� <br /> SIGN RE OATE <br /> Z� . �3 CI 9USINE55 LILENSE NO. <br /> PLUMBING MECHANICAL <br /> N0. TYPt OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEF <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION rAN � <br /> LAUNGRI'TRAY ; RANGE HOOD ; <br /> CLOTHES WASHER i WATER hIEATER � <br /> URINAL � WOOD SiOVE ' <br /> DRIDIKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> —�— <br /> FL.OUR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS� ; CaAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING ' <br /> i EXHAUST FAN i <br /> i i <br /> i i <br /> � i <br /> � � <br /> SUB70TAL S ; SUBTOTAL S ; <br /> PERMIT S � PERMIT S i <br /> TOTALFEE $ � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SET�ACK REAR SR�ACN 9UE SETBALK PLAN CI IECN NUMBER ' FEE RECEIPT NO. <br /> �3`° // /�/ <br /> USEZONE LOTAREA VACANTSITE EES VALUATION FEE <br /> ❑YES ❑ NO OUILDING � <br /> HEIGHT IJMITATION N0.OF DWELIJNG 512E OF BLDGR.I. i <br /> LINITS p�UM01NG i <br /> GfOUP�NCY N6.OFSi0RIE5 OCCU7ANTLOAD BASEMENT ldECH4NICFL i <br /> ❑YES ❑ NO i <br /> FlP.EAI.ARA�PEO'0 qEA50N ADDITIONALPLiNCHECN � <br /> i <br /> OTHER � � ni <br /> FIRE SPRINNLER REO'D REASON <br /> n STATEBUIL�ING UFCHARGE i <br /> TYPEOFCONST PIANS P,FOVE�BY CITY OF EVERETT P03LICN/OfiKS i <br /> T / LOCALSALES <br /> onre ! . �� i�� TAX CODE IS 3105 NTAL I <br />