Laserfiche WebLink
-��^2��� i � c3 57J'r2� <br />�'"U�"� APPLICATI�1 FOFt CONSTRUC'�N PERMIT <br />CITY OF EVE RETT • BUILDING DIVISION <br />3200 CEDAR STREEI • EVEFETT, WA 98201 • 259•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �PLUMBING ❑ SIGN <br />� NRECT OR DESIGNER M�IL �OORESS Gitt <br />�1�. ' <br />, �-, <br />C NERQGONTP i0R M�IL�ODPE55 LITY <br />MECHu11CALCONTR�CTOR MAIIADDRE55 f.ITY <br />��E�I�-� �+1N�in16� 135o R NE I?A�- <br />PUIMBINGCONTR�CTOR M�ILAODRESS CI1Y <br />CON�RICEj1F Y/ORN <br />-�� �i-� � - <br />�� ! V (/ <br />OESCPIBE WORK ANO SOUARE FOOTAGE INVOLVED <br />Pi10PO5ED USE OF BUILOIN6 <br />LEGAL UESCRIPTION OF PROFERT�' (SMOWN BELOW OR ARALH TWO COVIES) <br />LOT _ BIOCN OF <br />PAHCEL TiU( I.O. IAAIBER <br />CpISTRVC710N IOAN LENDER. /�DDRESS. TElEF110NE NUMBEH <br />PLUMBING <br />NO. TVPE OF <br />WATEH CLOSETi <br />UATHTUB <br />KITCHEN SINK E DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT <br />ciur �scavir.F _ aa� <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACN R! ��lScTBACN <br />USE ZONE lOT �RE� <br />HEIGNTLIMITATION NOOFOWEIUNG <br />UNITC <br />D�TE <br />FEE <br />SIDE SETB�GK <br />VACANT SIIE <br />❑ NO <br />PHONE <br />w�or+e <br />21P <br />ZIP <br />. <br />ST�TE UCENSI . <br />U1K�h <br />STAiE LICENSE � <br />HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br />CONTACT PERSON �ND PNONF NO 1 <br />I HEREBY CERTIFY THAT I HAVE READ AND t:'�MINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEflE1N OR <br />NOT. THE CaRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHEF STATE OR LO� LL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEflTY TO PERFORM THE WOHK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTO LAW 1827 RCW AN 296200 WAC. <br />w�� 3 z4 � <br />�GN�TURE D�TE <br />Cltt BUSINESS UCENSE NO. <br />NO. <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRVER; <br />RANGEHOOD <br />WATER HEATER <br />WOOC STOVE <br />METAL FIREPLACE <br />FIREPLACE INSERI <br />GAS FIREPIACE <br />GASRANGE <br />GAS PIPING <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE E <br />PIAN CIIEGN NUMBER � FEF I�Ef.EIPT NO <br />❑YES BUIl01Nf. <br />S�ZE OF BLDGR.I <br />PtVM01NG <br />BASEMENi MECHANIC�L <br />❑YES ❑ NO <br />�DUIIION�L CUN CHF.CN <br />pu�En <br />STAIE BUIlOING SUpCNAqIiE <br />CITY OF EVEFlETT �UBIIf. WOFNS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />0 <br />� <br />