Laserfiche WebLink
APPLICATI�.�1 i=(�R CONSTRUC7.ON ieERMdT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETI, WA 98201 • 259-8810 <br />C7 DEMOLITION ❑ COMBINATION I-1 BUILDING ❑ I!9ECHANICAL �'l PLUMBING f� SIGN <br />PROJECT ADDRESS <br />�.,nt� �,,,.��„��„t�� ���r ���• ,r,nt <br />r✓zre�+ �ol� i4oP Sr= ru2�tr c"�II wH�l �u�titr �„�n StJ�:r <br />TENANT MAILAppRE55 CI1' 21P PIfONE <br />/v1c.t1-re.s; C�n�-zr iyo? 5 F r�✓„r.++ Mcl! t�a� Su k �o i=uuY�7- c,��i 9���'s <br />FRCHRECTOROESIGNEfi MAI�AD�RE55 CITY ZIP PMONE <br />GENERAICONTPACTOP MAILqODRE55 <br />Cltt :.IP PHONE STATELICENSEx <br />h'ECHANICALCO�TRACTOR MAIiADDRESS CITV ZIP PHONE SiATELICENSE� <br />PIUMBIYGCONTRACTOfl IAFIL4DDRE55 Cltt ZIP PHO'lE ��S-(�4(�STATELICENSEx <br />.�cy cr il ��l-t, PI���. �.�r /P3�� NtJ � L� rnw�� l I.�A `i'yU3G �AYN1 <br />fONTR T PFIC[ OF WORH <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC L_ <br />DEFONI9E WOR AN� SOUAPE FOOTAGE INVOLV[D CONTAf,T PERSON AND PMONE NO. <br />Tntl-c�l M,,n C�nl� - <br />LEGAL �ESCRIPTION OF PROPERiV �SHOWN BELOW <br />LOT OLOCK - OF_ <br />CONSiRl1CTION LOAN LFN�ER. AD�RE55, TEIEFNONE NOMB@R <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />CLOTiiES WASHER <br />URINAL <br />FLOOR DRAIN <br />B�:,KFLOW PREVENTERS <br />SINK (SERVICE - BAR, El <br />� <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME i0 BE TFiVE 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 PFRMIT 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 />PEFFOFlMANCE OF COIJSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEH OF THIS PHOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS �+tADE AND I COMPLY WITH THE STATE <br />CONTRA�TORS LAW 1827 RCW AND 296200 WAC. <br />X U ' 'VVJ/ I� I S i�I <br />SIGN URE D�TE <br />CITY BUSINLSS LICENSE N0. <br />FEE N0. TYPE OF FI%TURE Ofl ITEM FEE <br />� A/C -A/HNDLG UNITS - H.P. <br />; FORCED AIR SYSTEMS - B.T.U. M E.A. <br />� HEAT PUPAP <br />� UNIT HEATEFS - B.T.U. M <br />; CLOTHES ORYERS <br />� VENTILATION FAN <br />' RANGEHOOD <br />� WATER HEATER <br />� WOODSTOVE <br />; MEiTAL FIREPLACE (WOOD BURNIMG) <br />-� FIREPLACE INSERT iWOOD BURNING) <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S J <br />�- <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REAR SETBACH SI�ESETBACK <br />USE20NF LOTARER VAGANTSITE <br />C YES fl NO <br />NEIGMTLIMRPTION NO.OFDWELLING S12EOFBLDGRI. <br />UNITS <br />OCGUPANCV <br />GROUP <br />REASOt: <br />FIRE <br />GAS FIREPLA( <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 5 <br />PENMIT $ <br />TOTALFEE S <br />PLAN CHECK NUMBER I FEE I RECEIPT N0. <br />BUILOING <br />PLUh101NG <br />BASEMENT MECNANICAL <br />f]VES fl NO <br />AD�ITIONAL PLAN CHEGK <br />OTHER <br />STATE O111L0ING SURCHARGE <br />CITY OF EVERETT PUBVC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />