Laserfiche WebLink
APPLICATI�� FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />fl DEMOLITION fl COMBINATION I1 BUILDING MECHANICAL t� PLUMBING fl SIGN <br />PROJECT ADDRESS <br />�i 5•f.. Cvtrtkt Mxll W2�.� Blcla 3 �%'� Fjaa� <br />ci�� zm ri�orve <br />z. S e2{�c Su� Fz �i 3U 9 <br />iatv ]IP . PIIONF <br />s.e <br />MICIIIIU:I Ufl Uf:51(iNf.fi M411 Afllllll'Sti GIIY J ]II` I•IIONf: <br />GENEfinIGONfOnClOfl MAILADUIlE55 GIY ZIP PHONE $UTELICFNSE� <br />MECNANIC�L CONTRACTOR MAIL ADDAF.55 CITV ].IP PIIONE STATE UCENSE � <br />_ . •. _ � . `. . . .• • � / • • . / . / • AA.� � / • �. /w /}..w / _ <br />PI110E OF WOfiN y <br />w <br />wonK nNn sounne Fa <br />nuu <br />. LEGALDESCRIPTIONOFPROPERTY�SHOWNBELOWORATTRCMTWOCOPI[S) <br />� �or ma:K or <br />0� dir2�wl�►QS <br />PARCELTNII.D.NUMBEfl <br />CONSTRUCTION LOAN LENDER. AO�RESS. TELEPHONE NUMBER <br />PLUMBING <br />BATHTUB <br />LAVATORV <br />SHOWER <br />OF FI%TURE Ofl ITEM <br />8 DISP <br />BACKFLOW PREVENTE <br />SINK (SERVICE — BAR, <br />FOR OFFICE USE ONLY: <br />FRONT SFTPACN RFAfI SETflACK <br />USE20NE IOTAREA <br />IIEIGIITLIMITATION NO.OfOWELLING <br />UNITS <br />OCQUPANCV NOOI S�UIIIfS OCCUPANI W�U <br />FEE <br />$ <br />$ <br />$ <br />SIUE SETBALK <br />VACAN( SIIE <br />Y <br />HEATING SYSTEM: f.�l GAS f� ELECTRIC fl <br />cowrncr rtnsoN nNn ri�oNe Ho. <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 COM?LIED 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 CONST RUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERYY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 27 RCW AND 296.200 WAC. <br />X f,�.�.. . 7- l7- 9� <br />SIGNATURE OATE <br />CITY BUSINESS LICENSE NO. <br />MECHANICAL <br />NO. TYPE OF ECUIPMENT FEE <br />A/C — A/HNDLG UNITS — H.P. ' <br />FORCEDAIRSYSI�EMS—B.T.U. M E.A. � <br />HEAT PUMP � <br />UNIT HEATERS — �.T.U. M ! <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLA( <br />F�REPLACE INSE <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUO TOTAL <br />PERMIT <br />TOTAL FEE <br />p� / I fEE I �ECEIPT N0. <br />/y <br />I IYES fi ND pl➢LDIN6 <br />SIZE OF OLOGRt - <br />PLUM(11NG <br />fiASEMENi MFCIIr1NICAL <br />f1YF.5 II NO <br />AUDIiION�L PLAN CIIECK <br />OTHER <br />STqE A111L01N0 SlIBC11r10GE <br />CITY OF EVERETT runur.wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />