Laserfiche WebLink
� <br /> APPLICATIO�� FOR COI�OSTRU�TIvN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> �`j DEMOLITION ❑ C MBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBlNG ❑ SIGN <br /> ,i ) <br /> PROJECT ADDRESS: � r V[r�en ��^`► J�3 // <br /> E✓¢re�k ��u2 �1vpTh.Car+� 1��0 3ox Scb's gellevvY 9&�`i Cy�s hs•i-G�// <br /> ONTlER �I �1�M���ILADDRE55 \ C'�ITY 21P PMONE <br /> NQW ZU$C�� �� J�GI�TNt/� � 1 LI/G /PC(1 V"'♦ L'�cieYr /��� <br /> 1ENiJIT MIJIAUDRES$ GT 21P PNONE <br /> ARLHITECTORDESIGNER M�IIAODRE55 CITV 71P �HONE <br /> �rtFN a.,..¢�., i �a�� i�"� �•NL '�Ile���e gk� (yas)7o�-(�b� �a�=�,t�-o� ��� <br /> GENEP�LCONTR�CTOR MMLADUBE55 n� �/J ��iY 7�� PIIONE SGTEIICENSE• <br /> —{///�U �j � ��O— �� <br /> A1ECH�NICALCONTRACTOR MIJIADDHE55 f.ITY Zlf` PIIONE STATEIICENSE <br /> PLU�MIGCONTRA�TOR MMLAOORE55 dtt IIP PHONE STATELIGENSE: <br /> ,#. �. �00 <br /> CONTHALTPRILEOFYprRK 1� � y HEATING SYSTEM: GAS ❑ ELECTRIC ❑ <br /> O n Wu�� U d'C/ �JA,KWt+. ��Kit� rIWU �(AL25 <br /> pE5(:RIBE WORK I1ND SOV�RE FOOTAGE INV VED CONTACT FERSON�NO PHONE NO <br /> m' � . k . � [,r. ���S.Se�1n � d� .��JS`/� (c(o <br /> � ` I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> a'c.� ` ApPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> rnoroseo use oF awinu+c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lEGl1L0ESCPIPTIONOFVROPERTY�SMOWkBELOWORAIT�CHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�ocK oF AUTHORITY TO VIOLATE OR CANCEL 'fHE PHOVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOPMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH TNE STATE <br /> PAqGELTA%1.0.NUMBEP CONTRACTO 5 L 1027 RCW AND 296200 WAC. <br /> u a oS - / -ooa -000 r,,� _3�_y <br /> CONSIRUGTION�ON7 LENDER./�DO�E55.TELEPHONE Nl1MBER <br /> SIG DATE <br /> CITY B�SINESS LICENSL NO. <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OSI ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE� � A/C—AMNDLG UNRS ' <br /> BATHTUB ' FOflCEDAIRSYSTEMS ,_ i <br /> � <br /> LAVATORY(WASH BASIN) � 4EAT PUMP ' <br /> — � UNIT HEATER:i � <br /> SHOWER � <br /> KITCHEN SINK 8 DISP � C!OTHES DRYERS ' <br /> DISHWASHER � RANGE HOOD � <br /> ' UIUNDFY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE ' <br /> � METAL FIREPLACE IWOOD BURNING) ' <br /> URINAL � <br /> DRINKING FOUNTAIN ' F�REPLACE INSERT(WOOD BURNING) � <br /> � <br /> FLOOF DRAIN GAS FIREPLACE � <br /> � <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING ' <br /> . � EXHAUST PAN � <br /> _ � � <br /> � <br /> � <br /> � SUB TOTAI S � <br /> SUB TOTAL S ; <br /> PERMIT $ � PERMIT 5 � <br /> TOTALFEE S � TOTALFEE S ' • <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBAGN PE�R SF.TBALK SIOE SETB�CN PIAN LIIECN Nl1M;G�j.�� <br /> fEF RECEIPTNO <br /> SC!�d <br /> FEES VALUATION FEE <br /> USE ZONE lOT MEA V�C�NT SIIE � <br /> ❑YE$ � N� ppll�ING ��� <br /> HEIGNT LIMITATION NO OF OWELLING 512�O"f�LIX:RI ��//��� � <br /> UNITS n i�{ ���JI� ""` ,_ PL114101NG � <br /> �Li !� �_ <br /> � <br /> OCCUP�NCY NO Oi SIOHIFS OGCUPANf LO�D BA NT MEG1nFlf.nt � <br /> GRWP ' <br /> OVES ❑ NO � <br /> AD�I fI0NR1.�'l AN C�IGLK <br /> FIRESPRINKLEflflEO'0 RE�SOt` �� <br /> pillEll <br /> FIHEALARMPEO'D RE N �� <br /> STA1E UUIl01N0 SIIRLlIRRGE � <br /> - T_ <br /> TY7EOFrONST PLANSA��OVE09Y CITYOFEVERETT f`lIBI1f,WORNS _ _ �_`_ <br /> M � LOCAL SALES � � <br /> o�TE TAX CODE IS 3105 TOTAL <br />