Laserfiche WebLink
APPLICATIC. J FOR CONSTRUCT. JN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> . 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOL.ITION ❑ COMBINATION ❑ BUILDING �-MECHANICAL �pLUMBING ❑ SIGN <br /> PROJECT ADDRESS:_ �fU�p �Go�l...r�.�c �� , � r��,T_ �� <br /> /j� �/i� � f7J'J,�(Mug�05� �F� �7/� c�rv r� r�wr+e �^ <br /> TElIMIT � MNI/�DpiE55 ✓ �iJ� • �O �� ZcJ � - Z G�i <br /> PIbNE �� <br /> Af1��MlECTOROESIGNER WIIADdiE55 CITY ]If' <br /> PHONE <br /> GENEMtCONTR11Ci0R MAIL�WDRESS �IIY <br /> ��� PiIONE SGtEIICENSE� <br /> ME CpHTRACTq1 �MAILADOHE55f/ CITY ZnIP PNONE q STAT/EJLIC'ENCSE� / <br /> (%����'���"'" _`T. � T���\/C{J�'��L ii'i�`�"L 7,�P�O� i-.lT //�� �//��JS��CoS f� <br /> VLULBMMCONTR�CTOR YAlLA00RE5S T <br /> ��tt �� PIqNE STATEIICENSE� <br /> CONiMCT FWCE OF wORI( <br /> HEATING SYSTEM: GAS ❑ EIECTRIC ❑ <br /> ��NlE MqYf 11MD SOU�RE FOO7AGE INVOWED COHT�CT PEf150N AND PHONE NO <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br /> Pnoroseo use oF emiqrq APPUCATION AND KNOW THE SAME TO BE TR!��AND COqRECT ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVEHNING THIS TYPE OF <br /> ����PoPT���ERTYI��OYM�BELOWORATTACNiNqCOP1E5) WORK WILL BE COMPUED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � ��T �� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCqL UW pEODUTINd CONSTRUCTION OR THE <br /> PEqFORMANCE OP CANSTHUCTION.THAT I AM AUTHpqIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> �L iNc i.o.wu�.eep CONTRACTORS LAW 1827 RCW AND 296200 WqC. <br /> CONSTRIIGTION IOAN LENOER.I10011E55.TELEP/10NE NIMABEN ����iQ�l�,� � �F7 / <br /> �(! C� <br /> ' Sd.N�TURE O�TE <br /> CITY BUSINESS LICENSE NO. <br /> ��� MECHANICAL <br /> �. TYPE OF Fl%TURE Op REM FEE NO. TYPE OF EpUIpMENT FEE <br /> WATER CLOSET(TOILEn � A/C—AMNOL(3 UNffS <br /> � �T�� ' / FORCED AIR SYSTEMS � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SFIOWER ' <br /> � ' UNIT HEATERS , <br /> KITCHEN SINK 8 DISP ; CLOTHES DRVERS � <br /> DISFryyASHER � RANGE HOOD � <br /> � LAUNDRYTRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE <br /> � <br /> �R�� ' MEfAL FIREPLACE(WOOD BURNING) � <br /> DRINKIN6 FOUNTAIN ; FIREPLACE INSERT(WOpD BURNING) ' <br /> FLOOR DHAIN � GAS flREPLACE , <br /> 9ACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING , <br /> ' EXHAUST FAN � <br /> i � <br /> � <br /> I � ' <br /> i � <br /> SUB TOTAL S � SU8 TOTAL S ' <br /> PERMIT S � PERMIT f � <br /> TOTALFEE S � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> FRp1T 5�7�'1�1( q��1q$�Tg�K SIDE SETBACk PLAN CIIECI(NUMBFR fEF RECFIPT NO <br /> usezar� LOT�REA v�awrsire FEES VALUATION FEE <br /> ❑YES ❑ NO BUILDINf � <br /> i <br /> NEqNT LIMITATION Hp pF py���Np SIIE pf&OORI � <br /> UNI75 <br /> PLUAIflING <br /> a�AMCY Iq pi 51ptlF5 p�CUPANT L011D B�SEMENT � <br /> MECII�NIC�I � <br /> ❑YES ❑NO � ,_ <br /> FlflESPR�NKLENHEO'D RE�SON AO�IIION�I.PIANL�Ilf.N <br /> . i <br /> i <br /> oniEn � <br /> FlIiEAIARMflEO'U pE�SON <br /> ST�IE BUIIUING SIIIICHARGE � <br /> TYPEOFf,pNST P�ANSAPPROVEDBY CITYOFEVERE7T �IIpIIf.Wp�IKS r <br /> LOCAL SALES _�_ <br /> DATE TAX CODE IS 7105 7oiAL . 1 <br /> i <br /> ;T-- <br />