Laserfiche WebLink
CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, \NA 98201 •259-8810 <br /> f-1 DEMOUTION �l COMBINATION �f BUILDING ❑ MECHANICAL CI PLUMBING rl SIGN <br /> PROJECT ADDRESS /��� G� ���v^ C � <br /> arv zir r��or+e <br /> OWNER MAILAD ess � .o�y, 154B Mu�Gt--r;a �i�A. Sz75 <br /> � �i1V�1�'S pHONE <br /> iENPNT ��M` �MnILA�D�E55~ ��ry Z1P �IO ��r�s� <br /> CIN ZIP PHONE Zp(O� �8�-qg�IQ <br /> ARCHREC DESIGNER MAILADURE55 �U��' <br /> Q1� A�/� • Z��' pH04E STATE LICENSE� <br /> MAILPUORESS ��TY O SM I �y0 • <br /> GENERALCONTRFCTOR �LS MI �� � <br /> QM y' ��l ��Y� s'�^ p110NE STAtE LICENSE h <br /> MECHANICALCONTi7ACiOR MAILAODRESS <br /> Citt ZIP <br /> Z�p PHONE STATE LICENSE� <br /> PLUMBING CONTRACTOR <br /> MAIL ADDRESS ��TM <br /> CONTRACTPRICEOFWORN a �S HEATINGSYSTEM: GAS �IELECTRIC G] <br /> CONTAC P SONAN PH ENO. <br /> OESCRIBE WORK ANO SOUAPE FOO GE INVOLVED ��-� I�O3� <br /> F�I s"� �•1�GTltr.['sf'�^ <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> PROPOS SEOF BUILQu+c PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH�S TVPE OF <br /> ,,, L1 M� <br /> � p ..+(�� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGRlDESCF�PTION FPROPERTV�SHOWNBElO oaa�n�HTWiCOPIES� AUTHORITYT OTVIOLATEAOR CANCELETHE PROV S�ION OF AINY <br /> �or�--B�aK oF � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �£� � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF TH ERTY NO� PERCOMPLY EW�OH KTHE STATE <br /> APPLICATION IS M <br /> CON R CTO LA B. 7 RC AND 296200 WAC. <br /> PARCELTA%IO.NUMBER y� � r¢ S <br /> r <br /> CONSTFl1CT10N LOAN LF.NDER.ADDRE55,TELEPHONE NUMBER D�TE <br /> SIGNAIURE <br /> CITY BUSiNE55 LICENSE NO. <br /> MECHANICAL FEE <br /> PLUMBING FEE NO. TYPE OF FIXTURE OR ITEM <br /> TYPE OF fll(TURE OR ITEM ' <br /> NO. � pIC—A/HNDLGUNITS—H.P. <br /> WATER CLOSET(TOILEn i FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> BATHTUB � HEAT PUMP � <br /> � � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B•T.U. M � <br /> SHO\'IER � � � � <br /> � CLOTHES DRYERS <br /> KITCHEN SINK&DISP � VENTILATION FAN , <br /> � DISHWASHER RANGE HOOD � <br /> � � <br /> ( LAUNDRY TRAY � � � <br /> , � WATER HEATER , <br /> � CLOTHES WASHER � WOOD STOVE � <br /> URINAL � � <br /> � METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(WOOD BURNING) <br /> FLOOR DRAIN GAS FIREPLACE � � <br /> � <br /> BACKFLOW PREVENTERS ' � � <br /> , GAS RANGE , <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> i <br /> ; _✓, EXHAUSTFAN � <br /> � � <br /> � SUB TOTAL S 1� <br /> SUB TOTAL 5 � pERMIT S ' <br /> PERMIT S ' TOTAL FEE 5 � <br /> TOTALFEE 5 ' <br /> (r�1� -� <br /> FOR OFFICE USE ONLY: FEE c� RECEIPT NO <br /> SIOESET K � ANCHECKNUMOF.q /„U •JC� /�I� <br /> Fi10NT 70�CN� EAR SFT/1pCK _ �r �J�7� (1� <br /> �y �Jo `� � � VALUATION FEE <br /> FEE <br /> LOTAREA VRCANTSITE �/ z �, i ��� <br /> USEZ .�P (IYES �NO "LZZ O7J <br /> J omioir+c n <br /> �� � q7 ITATION NO OFOWELLING SREOFBLWRSP t PWMOING /OS � v� <br /> ' UNITS I Z4y SF GA�Q�E ��(� I00 <br /> BASEMENT MECIIANICAI � <br /> OCGUPANGY NOOFSi0RIE5 OGCUPANTLOAD �/ ; O J <br /> GROUP� ^ ❑YES f1 NO <br /> V AO�IPOYAL PUN LHECK <br /> FIRE PLARM REO'D REASON �O �O� <br /> OTNER � <br /> i/-, <br /> FIRE SPRINNLER REO'D REASON STAIE OUILDING Sl1RCHA�GE �" <br /> .�O I D� <br /> pIANSAPPROVEDBY CITY OF EVERETT PUOLIC WORKS <br /> NPEOFCONST 1 , y LOCALSALES <br /> �J �a TOTAL /3 �D � �7 <br /> ��, DATE S Z �iS TAX CODE IS 3105 <br />