Laserfiche WebLink
APPLICATIC`I FOR CONSTRUCT���N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-8810 . � <br /> ❑ DEAAOLITION ❑ COMBINATION p BUIL�ING �MECHANICAL ,� PLUMBING ❑ SIGN <br /> PHOJECT ADDRESS: /O�// C/�Olfl�l �/lZ <br /> OYYqER MN1110011E54 p}y !IP VIqHE <br /> ,�A� /�lJLfiS�9S� //��// G/1O/1/ll/ GY1/ . C�/, �i>� o?S� -�4,�/ <br /> IEIMNT MN1110011E35 GtY �1P pIpNE <br /> ANLNiCGT0f10E51GNER 1MIlA00RE55 GITV /II' PIqNE <br /> 6ENEMlCONTMCiOR MAll�00RE55 CIIY 71f PIqNE SIMEIICENSE� <br /> MECN�NICALCONTMCTOR AWLA0011E55 CATY Itl` P110NE ST�TEIICENSE� <br /> F.�/ Si Ss,L���lJ�L /G//E/�,xi,�G///�3i��1' Q/ R�.�i? o?S,� �//'/ �UEjlGSS/.,?/,�7 <br /> PLU4BkM LONTiUCfOR M�IIADONE55 CIfY 11P PNONE Si�fE IICENSE• <br /> car+ra�crvnc�� HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br /> D <br /> pE XIpIMNO>OIIMEi00TA6ENVOWED GONT�CTi'ERSON/WpPIqHE/q <br /> / / ^ l( �� — �. <br /> 1 HEREBY CERTIFY THAT 1 HAVE REAO AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> rna�os¢o use oc�uunx+o PROVISIONS OF LAWS AND ORDINANCES GOVERNING TMIS TYPE OF <br /> � WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> �aKoescnwna�arnoaenn�y�ormee�owaa�rt�cHnwcovies� NOT. THE ORANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br /> 1O7 �p�yi pp AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> - OTHER STATE OR LOCAL UW RE6UUTINO CONSTRUCTION OR THc <br /> PERFOHMANCE OF CONSiRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH TME STATE <br /> NWCfLL1%1.0.M1A/ER CONTRAC LAW iB.27 RCW AND 286.200 WAC. <br /> COMSTRUCiION 101W IENDER.MDRESS.IELEP11dE NIMEER x (���� S '�� ' 7� � <br /> S�GN�NRE � DATE <br /> ' GiV BUS�NESS LCFNSC NO. <br /> pWy9010 MECNANICAL <br /> N0. TYPE OF flIfTURE 011 ITEM FEE NO. TYPE OF EOUIPAAElfi FEE <br /> WATER CLOSET(TOILEn ' NC—NHNDLO UNITS ' <br /> BATHTUB ' FORCED AIR SYSTEMS ; <br /> UVATORY(WASH BASIN) i HEAT PUMP � <br /> SHpYyEp � UNIT HEATERS ' <br /> KITCHEN SINK 8 DISP i CLOTNES DRYERS � <br /> DISHWIISHER � WWGEHOOD � <br /> LAUNORY TMY ; WATER HEATER � <br /> CLOTHES WASMER � WOODSTOVE � <br /> URINAL � MEfAL FIREPLACE(N/OOD BURNING) ' <br /> DRINKMNi FWNTAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> �ppp pq�N � GAS FIREPUICE ' <br /> BAqtFLOW PREVENTERS ; GAS RANGE � <br /> SINK(SERVICE—BAR.ETC.) � GAS PIPING � <br /> � E%HAUST FAN ' <br /> SUB TOTAL t ' SUB TOTAL S ' <br /> PERMIT S � PERMIT S <br /> TOTAL FEE S ' TOTAL FEE S '' <br /> FGii OFFICE USE ONLY: <br /> iRpITSEis�Glt PENiSET&1CN 510ESETMCN PIANG�FCNN'U4/Bf11 LEF NECFIPINO <br /> �-J � _ <br /> use ior� iot u�¢� veawt a�e :'EES VALUATION FEE <br /> ❑YES ❑NO � <br /> BUI Pn: i <br /> IIEI6NTUMITATION NOO�DWEWNO S�ZEOFEIOdf.l ' <br /> UNIIS Plll' �3 � <br /> � <br /> OC�CU�Y IqO�S�OnES OLCIIPANTIOM lASE►ENt y� r,�t � " <br /> OYES O NO � <br /> A1 �I�LPI�NCN(.CN � <br /> FIRE SPPoM(lER RE09 RF�SON _. <br /> FIREMN1A1f1E0'D RF�.iOH ' <br /> � <br /> nmID�NG SmICN��16E ' <br /> _'_ r— <br /> rrvear.owsr PIANSMM�OVEOBY CITYOFEVERF" �r.won�s ' <br /> LOCAL SALt.. - —�—� <br /> o„7E TAX CODE IS 3105 TOTAL ' <br />