Laserfiche WebLink
� <br /> APPLICATIG.�1 FOR CONSTRUC7 .dN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION fl COMBINATION f-1 BUILDING I-1 MECHANICAL r� PLUMBING fl SIGN <br /> PROJECT ADDRESS (�„ <br /> ��L, � Y��c� <br /> l�4� I / �lil� M^7lO�E� �• V IC�� � IJI .LIiYr.�C F/C� 21P�� PHON[ �^�O — /'� ` aL'= <br /> TEN�NT MM ADDRE55 CITY 21P PNONE C ") <br /> �l I��GN\�f IA ^IVl'_ ]E.i-I l • ���Ci �C 1 e �1 IIPC� C1�V I PHONF. /� �.� 1 — I�1 ' <br /> V <br /> GENERRLCONTRAGTCm AI ADDRESS QfY ]IP PIION[ StATELICF.NSE� <br /> MECN�NIC�LCONTRACTOR MAILAD�PE55 CITV ZI{' {'110NF STRTELICENSEi <br /> PLUMBING CONTR�CTOR M�IL RDDRE55 CIN ZIP PHONE STRiE UGENSE• <br /> GONTRAC_T PNIC�OyrOliK <br /> �� ��" HEATING SYSTEM: f I GAS �l ELECTRIC fl <br /> DESCPIBE WORN ANO SOUARE FOOi�GE INVOLVE CONTACT PERSON ANO PHONE NO. <br /> a <br /> �k �C I ' <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> VROPOSED USE OF BUILDIN PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEG�LDESCRIPTIIXJOFPROPERTY�SMOWNBELOWqiAR�CHTVIOCOPIES� NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GWE <br /> ior� e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PHOVISION OF ANY <br /> OTHER STATE OR LOCAL 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 /> D Fj OOO ^ S' � O o APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TA%I.D.NUMBER CO TRA TORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTRUCTIONIOANLENDER.PDDRE55.TELEPHONENUMBER X , �\ J� ]� W/�Y/�"IS <br /> SIGNRTUR DATE <br /> CITV BUSINESS LICENS[NO. <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ' <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASHER <br /> � VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD � <br /> y . <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL ' WOOD STOVE ' i <br /> DRINKING FOUNTAIN � METAL FIREPIACE(WOOD BURN�NG) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTER3 � GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE <br /> ' GAS PIPING <br /> —� <br /> ; E%HAUSTFAN � <br /> � ' <br /> � <br /> � , <br /> � ---T <br /> � <br /> � SUB TOTAL $ ' <br /> SUBTOiAL $ , --� <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE S ' TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fiIONT SFTfl�CK � REAfI SETB�CK � S�DE SETBACN PIAN CIIECN NI�MAF.R �[B i ��CfIPT NO <br /> ���' � 7/, sJ•!�S <br /> uSezoNe / IOTRREA \'RCAMSIIF FEES VALUATION FEE <br /> IIYES fi NO � � <br /> � Ol➢lC'NC � � ( <br /> HEIGIIT LIMIT�TION NO OF UWELLING $RE Of OIIX;�TI � <br /> J I/NlT$ �� �6 Ll1N.AING _�._ , <br /> � <br /> OCCUPANCY NO Of SIORi[S O(:CUPANi LO�D PASEMENT M(GInNIC4L � <br /> GROUP � / � — <br /> _ �I � IIYES 1(A� � <br /> F RE ALARM RE00 Rf�50N ��DIIIONAL PUN G��(CN � <br /> OIIIER i <br /> FIR[SPfiINNLGRREOD �fASDN -- � <br /> $TNEOIIItOMGSUfif.11nRCE � ' <br /> � J� <br /> TYPEOFf,ON$T rtnHsnrvnovgnov CITYOFEVERETT rueur,wonKs 1 <br /> �/� J�3— LOCAL SALES — — �--' <br /> iAX CODE IS 3105 i07AL � ' �J�� <br /> ���,EG s' - <br />