Laserfiche WebLink
.-. _ <br /> APPLICATI4.J FOR CONSTRUC7 _ JN PERM�T <br /> CITY OF FVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION � BUIIDiNG ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: �/' 2 �`/ �r-;� � •Q I�V � �1 � �t�/. L: r> �-'� • / <br /> CUC.�/�.y/ /,1,'PP � /� G.��1'l �aw� 1`Qs�/' Lttr � P /T 9C7203 C��� � �'Z — � 11�6 <br /> OWNEF M R1100RE S CITY Z� PIIONE <br /> IEHANT MAILAfIDfif.55 CIIY 71P �IIONE <br /> ARLHIT[GT OR OESIGNEf1 M�II�OORE55 LIfY ]n` P��ONE <br /> GENER�ILONiP�CTOfI M�ILApORE55 CIIY IIP PI:ONE Sf�fELICENSE/ <br /> � Ltl R �/\.� <br /> ME HANI�AICONTR�CTON M/aIADURE55 f.ITY 21P PIIDNE SIATELiCENSE/ <br /> PWMBINGCONTRICTOR M�IIAWRES$ Cltt Z�P PHONE STATELICENSE� <br /> CpITMCT PRICE OF WO{iN <br /> HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br /> OESCRIBENVfiK HDSOU�RE;OOTAGEINVOLV � CONT�GTPCRSDNAHDPMONENO <br /> P <br /> I HEREBY CERTIFY I�HAT I HAVE READ AND tYAMINEO THIS <br /> VROPOSED USE OF BUIlDINO 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 /> LEG�LDESGRIPTIONOFPROPERTY�SNOYMBEIOWOR�TTACNTWOCOFIE51 NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or�_eioc�O �D 1��7bv AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFIIRM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PMCEL TA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> - -� O 0 �do p/` <br /> CONS1AlICTION IO/�N IENDER.�DDnE55,TElEP110NE NUMBER �i�o������'�,� I O -��` /{, <br /> ATURE D�TE <br /> CI1Y BUSINESS UCENSG N0. <br /> PLUMBIN(i MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEH CLOSET(TOILET) � A/C—AMNDLG UNfTS ' <br /> BATHTUB ; FORCED AIR SYSTEMS ; <br /> UVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER ' UNITHEATERS ; <br /> KITCHEN SINK 6 DISP i CLOTHES DRYERS i <br /> DISHWASHER � RANGEHOOD � <br /> UUNDRY TRAV � WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' ME7AL FIREPIACE(WOOD BURNING) ' <br /> DHINKING FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) � <br /> FLOOR ORAIN � GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE � <br /> SINK(SERVICE—BAR.ETC.) � GAS PIPING <br /> EXHAUSTFAN <br /> � <br /> � � <br /> � � <br /> � ; <br /> SUB TOTAL f ' SUB TOTAL S ; <br /> PERMIT S � PERMIT S � <br /> � TOTALFEE S � TOTALFEE S ' <br /> FOFi OFFICE USE ONLY: <br /> FRdJT SETB�CN RF.AR SF.TB�CN S�OE SFTB�CN �UNGIIGCN NU1AAfR �EF AEf.EIPI NO <br /> 53 3i� <br /> usE zor�e ioT enEn V�CANi SItE FEES VALUATION FEE <br /> ❑YES ❑ NO OUII�iNf �� i DO <br /> NEIGMT UMITATION NO OF�WEIIING SIZE OF OIOGRI <br /> UNIiS PUIMOMG i <br /> OCGUPANGY NO Of SIOPofS OCLU�ANf LO�D BASEMENI MEf,1lnNlf.�l � <br /> GRWP <br /> ❑�ES ❑ Nq <br /> FIPESPRINKLERREO'0 �E�50N �OUIIION�LPUNC�If.CN _ <br /> i <br /> omen <br /> FINENARMREO'D RF��ON �! <br /> S1AIL01"I�INC.SUliG1U0GE —_ �� <br /> 1 <br /> irP¢oFr,or+sr PL�NSAPPlIOVEOBY CITYOFEVERETT runnr.wonKs � <br /> LOCAL SALES — — —''-- <br /> o��E TAX CODE IS 9105 TOTAL <br /> `� �_ <br />