Laserfiche WebLink
APPLICATIA FOR CONSTRUCAN PERMIT <br />CITY OF E - EVE • BUILDING DIVISION <br />,� /// 3200 CEDAR STREET EVERETT, WA 98201 • (425) 257-8810 <br />El DEMOLITION Ly COMBINATION (BUILDING LW MECHANICAL ❑ PLUMBING *IGN <br />cpNmACTPACE o<YA)11K <br />P,C-CA-LL CPACE �S A (=S C4,cc <br />_ E— " <br />HEATING SYSTEM: ❑GAS ❑ ELECTRIC <br />MSCROF NOR. AND=UAPE TWINGE NMWO <br />Coll, -CT PERSON AND rNOAF NO <br />P RLcI< C V-lL'CCI� -t_L <br />PP.6CR CSa3� 6aq-QQ2S <br />��-MILLI. S7�lGC <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />COONTRA•;T:,RS LAW IS 27 RCW AND 296200 WIC <br />nroroRpusEa BunpRD <br />LEGAL pEscMrrlL>H orrroMnn lsrvmf BELOwpI AnACN TING COPIES) <br />LOT BLOCK a <br />rARC[l rAEI R En — r <br />CONStnp:IgNlOAR1ENf1EP, AOMESS. iE1EPIgNE NUUBEn <br />SIA Un`R <br />E DATE <br />G1Y BUSINESS LICENSC NO <br />PLUMBING o <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPEOFEOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AFC —AMNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />SHOWER <br />S <br />KITCHEN SINK 6 DISP <br />__ <br />VERC <br />DISHWASHER <br />_ <br />XRANGOOD <br />LAUNDRY TRAY <br />R-- <br />CLOTHES WASHER <br />URINAL <br />METAL FIREP CE(WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSE (WOOD BURNING) <br />FLOOR DRAIIJ <br />i <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GASRANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />I <br />SUBTOTAL E <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />TOTAL FEE S <br />TOTAL <br />FOR OFFICE USE ONLY: <br />f MINTVIR4.K <br />PEAP Ei16ACK <br />SIDE Sf TBACK <br />PEAR CRECK PLAEP <br />!FF <br />RECMMN, <br />(lo�a,� <br />g/a5o <br />USE tONF <br />101JRFA <br />VAUNT WE <br />FEES <br />I VALUATION <br />FEE <br />_ <br />❑rf5 ❑No <br />PUIMNOil' <br />W— <br />'\ <br />7 iJV <br />NEMNTIRRIADON <br />f DftLLING <br />SIZE OE'Bl00nl <br />MOORING <br />pCCVPA\;; <br />wrvq•w.NNN110Ap <br />BASf OENI <br />4if.14NM:q -- <br />❑rts NO <br />AOpRp1AI MANPRCK <br />-- <br />_-- _.- <br />) <br />FIRE SMiVIXIFR PE9'DpN <br />--�-- <br />OUKP <br />FIRE PLEURA PIOU <br />L ` <br />Rf ASnV Z,-�r& 1�II <br />1u ij MN <br />f1A1f ED, n�P SunCNAM:E <br />Trrf Mrprm <br />MNN/S APlmovfner <br />CITY OF EVERETT <br />.InL:wpuR <br />V <br />LOCAL SALES <br />TOTAL <br />D•lE �- <br />TAX CODE IS 3105 <br />