Laserfiche WebLink
APPLICATIf�'V FOR COWSiRU�CT�N �ERi�IT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING � SIGN <br />PROJECT ADDRESS: _ �J %y D EI/E�i-%Z,E'E^) W y <br />OWNER u�aeooness cm ziv PNONE <br />1iRN�E ICEGp� 98� L''voel,�GF�ra wy ��r 98Z04 353-1119 <br />TENANT � MNL�Dd1E55 f.I1Y IIP PI�ONE <br />f.IIY <br />� <br />uu� <br />PIIONF <br />PiIONB SUTE IICENSE • <br />�losz-382�i RPo�.n►royyoD <br />P1ION[ STATE LICENSE � <br />PLUMBINGCONTR�LTOR MML�ODPE55 GfY 21P P/IONE STATELICENSE• <br />WORK <br />ioi <br />FOOTAGE <br />vaovean <br />BLOCK _ <br />..-�-i��2 �4 -3 - 03/ -Do0 � <br />CONSiRUGT10N IONI lENOER. �DDRE55. TELEPIIONE NUMBER <br />PLUMBING <br />OF FlXTURE OR REIA <br />WATER CI <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP <br />CLOTHES <br />DRINKING FOI <br />FIOOR DRAIN <br />SINK (SEflVICE — <br />Fpp OFFICE USE ONLY: <br />FRONTSETP�CK PE�R SFTBACN <br />USEZONE <br />IIEIGIIT UMIT�TION <br />GG�COU�ANCY NO Of S <br />FIflE SP(UNKLEp pE0'D <br />LOt�aE� <br />7W0 COPIE51 <br />SUBTOTAL S <br />PERMIT S <br />NO OF DWELIING <br />UNIIC <br />RE�SON <br />SIOE SE7B�f.N <br />NEATING SYSTEM: ❑ GAS ❑ ELEC7. : ❑ <br />VIiN M� �rT1�7�-� !(r�V.v 1-c.n� ��. <br />3G0) %52- 342.�j <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT qLL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTFiER 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 />CONI'RACTO 5 LAW 1827 RCW AND 296.200 WAC. <br />�, ��C�,l ,��s��� <br />$IGWRUHE O� / � I I �iE <br />CI fY BUSINESS IICENS[ NO <br />NO. I 7YPE OF EQUIPMENT I FEE <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />RANGEHOOD <br />WATEFi HEATER <br />FIREPLACE <br />GAS PIPING <br />SUB TOTAL f <br />PERMIT E <br />TOTAL FEE f <br />PlANC11ECNNUMflPR fff OFCFIPTNO <br />�.39�'� !:�S?� <br />V�CANI SIIE YCCJ <br />❑YES ❑ Nb pUILI]ING <br />SIZE OF BlUG91 <br />Pl�I6�01NG <br />B�SEMENI MECIUNif.�L <br />❑YES ❑ NO <br />P�OI I IONAL PUN CMf CN <br />01MEfi <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />SIRiE OUIIOMG $UBCIIAi1GE <br />rum ic wnnKs <br />TOTAL <br />