Laserfiche WebLink
� <br /> APPLICATIO_ . FOR CONSTRUCTI.�N PERMIT <br /> CITY OF EVERETT•BUIl.DING UIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 9gpp1 •259-8810 <br /> p DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING O SIGN <br /> PROJECT ADDRESS: �Q12� � �.�-� �� (�$2� <br /> S���R 1'a��-r�s - 9�s i���" � s� �.�,� a. ��s -4�3- i�� <br /> uwnen unt�ooness zm rHor+e ' <br /> �'T�K. �io�.� lotzl z� Ink�.,�� ��'r� Wa �8204 ` <br /> TENANT IAAIIADOnC55 CI7Y . . . \ ;, �`� <br /> 1��_ .� ZIP PIIOHE • . . '_.:`1 ,.. <br /> rlG��r.IL �� �}aeµ,. 16eo-13�� j'c� N�. �ug,,� kl�- L78f�i 2F.� 747 3i�7 - ' <br /> ARGHITECTOROE516NER MAll�00RE55 ��n. ��r i'c ��,-' <br /> _ 7pfj� PHONE -� <br /> roc� n-�j �; <br /> GENERALCONTR�CTOR MAIL�DORE55 �i1Y zi� �F,^ <br /> —� PIIONE SGTELICENSE� <br /> Np <br /> :< <br /> MCCHANICALCONTqACTOR MAqADDRE55 ,t �' {f�V <br /> N/A an nr <br /> PIIONE STATE IICENSE� ' ` ' �� ' <br /> r� <br /> (SO <br /> P MBINGCONTfl�CTOR M�IlA00RE55 CIIV ZIP PHONE <br /> � � �/ ` SUtE UCENSE� � f 4, <br /> t . <br /> /� ��� � �� <br /> COt�jt1ACT PPICE OF V�PI( - <br /> "`� � HEATING SYSTEM: � GAS ❑ ELECTRIC O <br /> DESCRIBE WOPK ANO SOUARE FOOTAGE INVOIVE� TAGT PEFSpyANA PHONE N0. <br /> 'IS2 S�F RA'�Y��-CgIL �_n2.�-�. M 2� - �(4`t - 3��� <br /> I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS <br /> PROPOSEDUSE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALOESCRIPTIIXJOFppOPERTY�SHOWN9ELOWIXiATfALNTWOCOPIES) �'�'�RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ��T ���K oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTIiER STATE OR LOCAL LAW pEGULATING CONSTqUCTION OR THE <br /> PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � PAHCELTNf I.D.NUMBER CONTRACTORS LAW iB27 qCW AND 2g6200 WAC. <br /> +!242 30 • �so •Qv �/� <br /> CONSTRUGTONIOANLENDER,ADORESS,TELEPHONENUMBER </J//� //�,_,Q/ <br /> /p <br /> — ' / si�r+a.ur�e� � lc� o�re <br /> CITY BUSINESS UCENSE NO. <br /> - PWMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNRS � <br /> BATHTUB ' FORCEDAIRSYSTEMS � <br /> LAVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER � UNITHEATERS � <br /> KITCHEN SINK 8 OISP ; CLOTHES DRYERS � <br /> DISHWASHER ' <br /> ' RANGEHOOD , <br /> LAUNDAYTRAY ; WATER HEATER � <br /> CIOTHES WASHER � WOODSTOVE � <br /> URINAL � METAL FIREPLqCE(WOOD BURNING) � <br /> ORINKING FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) ' <br /> � FLOOR DRAW � GAS FIREPLACE , <br /> BACKFLOW PREVENTERS � GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING , <br /> ' EXHAUSTFAN <br /> � <br /> ; <br /> � <br /> i � <br /> i � <br /> SUB TOTAL E ' SU8 TOTAL E ' � <br /> � � <br /> PERMIT $ i PERMIT S � <br /> TOTALFEE S � TOTALFEE S � <br /> FOR OFFICE USE QNLY: <br /> FPONT SETB�CO� REnR SET9f.;N SIUE$�ETB.:CN P�AN LIIECN NUMOEf1�� fE���O iiECEIPT NO <br /> USE ZONE LOT AREA VACANi SIIE F ES VALUATION FEE <br /> C�� ❑YES NO pUILDINC �yy�� � <br /> HEIGHT UMITATION� NO.OF DWELLING SIZE OF BLDGR. r�r � I <br /> }-7� UNIfS � `w � /�� p�pA1pING � <br /> 7�/ �•+Il /V <br /> - OCCUPANCY Np 0�SIO ES OCCUPANf LO�O BASEMENT AICCf1ANICAL � <br /> GROUPn <br /> V �� �� Q�•ES �rv0 1 <br /> i <br /> � FIRESPRINKLERFEOD REASON ADD�IIONALMANCMf:CK <br /> i <br /> �G omen ; — <br /> FIREAIARM�RnEO'D PEASpN <br /> /v" � <br /> STRiE OWtORl6 SUIiC11Rf10E —�� <br /> TYPEOFf,ON57 cinNsnrrnoveonv CITYOFEVERETT rueiir.wonKs <br /> `� l,�M �OCAL SALES — —� <br /> onre 11 ZjJ Af TAX CODE IS 3105 7o7AL � . � <br />