Laserfiche WebLink
APPLICATIGA FOR CONSTRUCT.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 99820'i • 259-8810 <br />,..,.t,.,., " of IIIn1mr_ I MECHANICAL F-1 PLUMBING f1 SIGN <br />IJ UEMULIIIUIN J Auwloillml w,.-•--•••- - - - <br />PROJECT <br />ADDRESS <br />OWNER MAILADORESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE, <br />9JIL-DIwr-kim"tt" S>F Z3�3 1zn 'PvENE Inln'S `t�s�� �62�8-9Sz1 334 8LZ5 BAEwNLICENSE <br />106312q <br />—1L(8341 <br />LICENSE Y <br />ONTRACT PRICE OF WO r ,7 / Qcl � I.{ Q $YSTE -' i�"Qh'!; C%]'1=LECTRIC El - <br />DESCRIBE <br />LEGAL DESCRIPTION OF PROPE <br />LOT BLOCK <br />a <br />BELOW OR ATTACH TWO <br />PARCEL TAX LD. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />_CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />SINK (SERVICE — BAR, <br />SUB <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK REAR SETBACK <br />US -ZONE LOT AREA <br />HEIGHT LIMITATION NO. OF DWELLING <br />UNITS <br />PEG <br />DATE <br />FEE <br />S <br />S <br />S <br />SIDE SETBACK <br />VACANT SITE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />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 />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC ORS L7 18.27 RCW AND2?P.200 WAG. <br />SIG" RE GATE <br />CITY BUSINESS LICENSE NO, <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C — AIHNOLG UNITS — H.P. ' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS ' <br />VENTILATION FAN ' <br />RANGE HOOD <br />WATER HEATE <br />WOOD STOVE <br />TOTAL $ <br />IT $ <br />4L FEE $ <br />PLAN CHECK NUMBER_ PEE IRECEIPT NO. <br />❑YES ❑ NO <br />BUILDIHG <br />SIZE OF BLDGIT.I. <br />PLUMBING <br />BASEMENT <br />MECHANIC(' - <br />❑YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />