Laserfiche WebLink
APPLICATIL�� FOR CONSTRUC7.AN �ERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL I-1 PLUMBING ❑ SIGN <br />PROJECT ADDRESS: <br />g =o� T-���, ,� Gv.i <br />/ """"""^'cao — CITY / ZIP � - PHONE <br />�� S <br />GENER�LCONip�CT08 IAAILADORE55 CITY ZIP PNONE S�ATELICENSE� <br />CONTMCT PRICE OF WORK <br />HEATING SYSTEM• ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE NqHK AND SOUIPE FOOTAGE INVOWED CONT�CT PERSONANO PHONE NO <br />� <br />LOT BLOCK <br />e."��. <br />CONSTRVC110N IOAN LENDER, AODRE55. TELEP41pNE NUMBEq <br />PLUMBING <br />NO. TYPE OF FlI(TURE OR ITEM FEE <br />WATER CLOSET (TOILEn , <br />BATHTUB � <br />LAVATORY (WASH BASIt.) , <br />SHOWER � <br />KITCHEN SINK 6 DISP ; <br />DISHWASHER , <br />LAUNDRYTRAY � <br />CLOTHES WASHER , <br />URINAL � <br />DRINKING FOUNTAIN ; <br />ROOR �RAIN � <br />__1 <br />BACKFLOW PREVENTERS � <br />SINK (SEfiVICE — BAR, ETC.) , <br />SUB <br />TOTAL <br />E <br />FOR OFFICE USE ONLY: <br />iRONTSET9�CN REAR SETBACN SIDE SETO�CN <br />USE20NE <br />NEIGNT �IMIiATION <br />Iq Of SfCNUES <br />U�'l (�1�� .3�-�r7r�v <br />d <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 WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE G�ANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION �F ANY <br />OTHER STATE OF LOCqL LAW REGULATiNG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I 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 />CONTRACTORS LAW 1B.�D 296200 WAC. <br />��( O .� <br />SIGN�TURE �—/ p TE�� <br />CITY BUSINE55 LICENSE NO <br />MECHANICAL <br />NO. TYPE pF EOUIPMENY FEE <br />A/C —aHNoi r, t iurta `— <br />FORCED AiR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />WATER <br />GAS RANGE <br />GAS PIPING <br />IXHAUST FAN <br />PERMIT E <br />TOTALFEE 3 <br />PLAN CIIECN NUNBEji � iEE � RECEIPf NO <br />LOi 11REA VA�ANT SITE FEES <br />❑YES ❑ NO pUILUING <br />NOOFDWELUNG SIZEOFBLOGRI � <br />UNI75 <br />PLUINBING <br />OCCUPANiLOAD BASEMENT MEGNRNICAL <br />❑YES ❑ NO <br />RFASON AOU�IIONRL PLAN CI�FCK <br />OTMEP �� <br />RE�SON <br />STAIEBUIL�IN SUPLHRI <br />PLAN, {�Paoveoer CITY OF EVEREIT �11911f, WORKS <br />N� <br />LOCAL SALES <br />onTE �j- �ii-�'Ir TAX CODE IS 3105 TOTAL <br />