Laserfiche WebLink
� <br /> APPLICATIGr� FOR CONSTRUCTrJN PERMIT <br /> CITY OF EVEREiT•BUILDING DIVISION <br /> 3200 CEDAR STREEI'•EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION I� BUILDING ❑ MECHANICAL ❑ PLUM@ING ❑ SIGN <br /> PROJECT ADDRESS: �I�_ �i`�l GLPhUJ 00� _ �UP��I-} �,v�,. <br /> O�M�EN MeIt�00RE55 CITY 71P PnONC <br /> CHAI'lfls �du�.�.t �I134 G1ilinwocl EvPr�}} <br /> �EHANT MMLMdiF.55 fATY )IP 1`nONE <br /> A{i�MTEGT Oii DESIGNER M�It ADORE55 CITY )II• �IIONF <br /> GENEMLfANTR�CTd1 MAILQIDRE55 �IfV 7R PnONE cUTEIILENSE� <br /> moecoN Zur_ a,o. oox �sy Gr����e ���c q�s� 6����,��L w��r�o� n���� <br /> MECMIIN�CJILCONTRACTOR MMLADDRE55 qtt )m FIIONE ST�TEUCENSE• <br /> PIUMBWGCONTR�CiOR M�IlAODRE$5 �ItY )11' P110NE STATEIICENSE• <br /> CONiRAGT iRICE Oi WppK <br /> ' HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> O/E�SCiMlE WORIf A/A$dJARE FOOT�('iE INVOLVED I 1 f,0111� f PC�SOHANO PHONE Iq <br /> _l)4�4vP �C4�. 40.P� �S'U� C4�-l. �� Nl '� Z � <br /> I HEREBY CERTIFY THAT I HAVE READ AND ExAMINEO THIS <br /> vnovoseo�a e aarq APPLICATION AND KNOW THE SAME TC AE TRUE AND CORREC7 ALL <br /> PROVISIONS OF UWS AND ORDINANCE�GOVERNING THIS TYPE OF <br /> CU Q C4f y WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �cuoescarna+ ROPERtt($NOWNBELOWORAR/�LHTYpCOPIES� NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �Or e�ocu oF. AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOCAL LAW qE�ULATINO CANSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> VNICEL UU(I.D.MIMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> _S�S��a000'4i-oS'� - /� <br /> CONS1PlIGT10NlON1lEN0EP.l1DdiE5S.TELEP110NENUMEER �.� � /��Lti�._ Q� I71� �� <br /> SIGN�TUii� DATE <br /> CIIY BUSINESS IICFN:iC NO. <br /> P�V��� MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CIOSET(TOILET) � NC—NHNDLp UNfTS � <br /> BATHTUB ; FORCED AIR SVSTEMS � <br /> i <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNIT HEATERS � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> OISHWASHER � RANGE HOOD �— <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOODSTOVE �— <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) � <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKROW PREVENTERS ; GAS RANGE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING <br /> EXHAUSTFAN <br /> � � <br /> � �_ <br /> � —�— <br /> SUB TOTAL S ; SUB TOTAL f ; <br /> PERMIT S � PERMIT f � <br /> TOTAL FEE S � TOTAL FEE f <br /> FOR OFFICE USE ONLY: �"��/� • �- -G • <br /> FIqHT SETPACK / RE�R SETBQj( / SIOE SETB�C� PI AH CIIEC�uuorn FEF n ,/� �Ef.EIPi NO <br /> n� <<� S 2 �� <br /> USE IONE LOT 11REA V�CANI SITE FEES VALUATION FEE <br /> � r <br /> ❑YE$ ❑HO pUII�INC. 7 .fZ �� <br /> NEIGHT LIMITATION / � NO OF OWEL4NC SRE OF BLOG/f.l i <br /> Z UN175 � <br /> O .S riuunnm <br /> OCCUPANCI' W p SIMtlES OCCUPANTLOAD BASEAIENT �— <br /> CRqR MfC11�NILM � <br /> � ❑YES NO <br /> FIRESPRINIQEqREO'D �EASON ADIAilONA1.�InNCnfCN <br /> --i-_- <br /> on�cn <br /> FIREAURMREO'D FEASON <br /> St�lE9UI�01N65U11C11M10E — i%�� <br /> VL_ <br /> TYPEOfCONS� PIAHS�PPPOVEDOY CITYOFEVERETT rimnr.wnnKs <br /> LOCAL SALES --- — -'— <br /> o.te TAX CODE IS 3105 TOTAL Gj� ;. �j� <br />