Laserfiche WebLink
� \ <br />L: f 3 APPLICATI4. � FOR CONSTRUCTI �N PERR�#IT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ QEMOUTION [I COMBINATION � BUILDING C�MECHANICAL � PLUMBING ❑ SION <br />PROJECTADDP�ESS:��_����_������_E_ _'[v�oFTT uJN <br />OWNEH <br />M��L �DDItE55 <br />cirv ni� rnor+c <br />Lv�,,.��/ �iMo36 /zo� 1 7� 7- 6 7� o <br />�cwwr MUL�00i1E55 �.,J c.nv 7�r f`HpHE <br />�RCNITECT �SIGNER M1111 �DCaE55 ��T'� ���` �MONE <br />pLo<Y�1 G,^as )i! S l'uNOis�r�J CJc•�� _y82�' 3 Zob) 3S 3-�US`3/ <br />GENER�l9NiMCT MAItlIW0E55 f.11Y :II' Ey�'�10NE $GTEIICENSE� <br />ELC-c�r�lc.��I 1 � y <br />�f11C/Y4 Lun�7/o[7��3 �ZV <br />MECH CONTRACTpR MNLAODRES <br />Ec.C�7F� c��j L �p� <br />`sM11Cl4u iun7i4t7cIC5 (�2() <br />%UMBI ONTR�CTOR M�ILAUDpE55 <br />ELECT�IL�(. <br />rYLc/44 Cw�'f/4���i75 7G%U ; <br />CONf PoCE OF YYpnN <br />�GT,u�;u_v✓ /.��t G�K�<��./ <br />OE BE WOi1N AND SOUARE F1OpTAGE INVOIVE <br />`i.��C�.r �an,�lu.c-/cu•, f2<, <br />3�Z � S4 / / ��J:..y . <br />y <br />Pf10►� D VSE 9F BNLDINO / <br />�1 � ( !� t� L � .n <br />iew� oex r a• rrrorEn/! L� <br />ioT _.�_ e�o:�c -- a <br />S�W�'/YufN•C <br />�l� G�^co�ttW�{ Ly✓�k�Yo�:A We! Ci'UG,��ii'%-67uu ELE�rELIbU.TE <br />5 ` CI�—� n' —_ f��' ���ONE $UTE UCENSE • <br />.l{l3 G�nccln f.tJay %j.�<<✓u�,.-f WcJ �IL'(J3G (Lu6�7t�7-bZd� [-Gr2jEC./�iNE <br />CI Y tlr PlIOHE STATE LICENSE � <br />y;ti, / J <br />or+�n�cNTwo <br />J /fGS / � <br />s�c 1�,7�P 2`�kLL�i <br />I�WRE55. TELEPIIONE NUMNER �" <br />5YC �lcu1 ,SfSn$� <br />7 <br />,l S . % /oo %/r//�uHeGJxr <br />TYPE OF FlXTURE OR ITEM <br />WATER CLOSET�TOILEn <br />LAVATORY <br />KITCHEN SINK 8 DISP <br />CLOTHES WASHER <br />DRINKING FOl <br />FLOOR DRAIN <br />SINK ISERVICE — <br />SUB TOTAL S <br />FERMIT S <br />TOTALFEE E <br />FOR OFFICE USE ONLY: <br />ippNTSETRACK REARSFfB�CI( <br />^�� � / <br />!!c' <br />USE20NE �j IOTARF� <br />'�- � ��. <br />HEIGNT UMITAiIQN _� NO Of IIWELUNG <br />JS UNIiS � <br />FlRE <br />� NEATING SYSTEM: <br />f.01liAG f PCI150N �HD PNONE <br />❑ ELECTRIC ❑ <br />�v�_��li4__F4T�� ) i"v 7 - 67 00 <br />„��- ti, s�� � ��s�) 3> >- y733 <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE iAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF lAWS AND ORDI�A.NCES COVERNING THIS TYPE OF <br />WOPK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE 6RANTIN6 OF A P[RMIT DOES NOT PRESUME TO GIVF <br />AUTHORITV 10 VIOLATE OR CANCEL THE PROVISION OF ANY <br />OtHER STAIE OR LOCAL LMY REGULATIN6 CONSTRUCTION OR THE <br />� PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFOHM THE WORK FOR WHICH <br />)�t< APPLICATION IS MADE AND 1 COMPIY WITH THE STATE <br />CONiRACTORS LAW 18.27 RCW AND 296200 WAC. <br />x � i���/�tty 2 �55L <br />5 �T f1EO,Z7� rn DATE <br />� � .i <br />G.– COV flU51NF.55 UC[NSC NO. <br />MECHANICAL <br />SIbE SETB�CN � <br />�_ <br />VAC�Nf SIfF. <br />� /ES ❑ NO <br />76��SF CIv�nI[ <br />5 S,F. GAnPG <br />B�SEMENI � <br />j]Y�C �i0 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAl( CODE IS �105 <br />TYPEOFEOUIPMENT FEE <br />/VC—A/HNDL6 UNfiS <br />FORCED AIR SVSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />RANGEHOOU <br />WAIER HEATEfl <br />WOOD STOVE <br />M[TAL FIREPLACE i <br />FIREPLACE INSERT <br />GAS fIF1EPLACE <br />GASRANGE <br />GAS P�PING <br />E%HAUSTFAN <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />PtANC11Gf.NNI11Alif0 fEF � BECEIPINO <br />{,-�� � 3d �- <br />OIIIIOWti <br />PlUA�111N1: <br />MFCIInNll:n1 <br />�DIIIIIOrV' PUNL�IfCN <br />Oillfll <br />SIAif Oinl U�rlli SI I�U:���f10F <br />191p1 If wnPrcG <br />TOTAL __ '�'—�--- <br />