Laserfiche WebLink
APPLICATI� FOR CONSTRUCT�N PERMIT� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •257-8810 <br /> ❑ DEMOLITIOiJ ❑ COMBINATION ❑ BUILUING - MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTAD�RESS <br /> OWII P M4L�C0{1E$$ CItY ZM PNJNE <br /> �, �/�5 -�3 -��k� <br /> iEN� MML��DPES$ �:li� ZiV VIqHE <br /> ARCNIlELi0P0E5GN[P Y�IU�ME55 Clb Lip PNGflE <br /> GENCP�ICONiPACiOB M�R�pDPLS LI1Y 1'P �MONE Si�IELIGENS[• <br /> ltc�7�i-t'I�f1✓r ,11�' �`/dX Ar�,t�}�_������ S� 73tY/ <br /> uecr�erncn�cori.r. rcr �.�uuoones� cnr :m ��1 ' v�ror�c rnicv„r. <br /> ' �SNau�vN+rn�r� <br /> PWM9�NGfO11iPALtOP R�iLA00PE55 CIiY IiP PHON[ SUtLLICUISE� <br /> CONIPALL VPKE OF W0116 <br /> T HEATINGSTjiFM: ❑GAS , �ECTRIC ❑ <br /> oes:.nieewanKu+owu�acioouc�urv vm �. coryr�c�vcawx�.r+o���o�:�ir lY,.�� ! 3/fn,_��_.� <br /> _�dl�� a°.'.$!y�._� <br /> � �� V <br /> I HEREBY CERTIFY THFT I NAVE READ FNU EXAI.IINED THIS <br /> APPLICATION AND KNOW T:iE SAtdE TO BE TRUE AN�GORRECT.ALL <br /> rnovose SE ovammrti pqOVISI0N5 OP fAWS AND ORDINANGES GOVERNING THIS tVPE OF <br /> N'ORK YlILL BE WMPUED NITH WHETHER SPEGFIED HEREIN OR <br /> icc��oescairuosoFvaovearvisnowr�ee. onerreo�mocovies� NOS THE GRANiING OF A f'ERMIT DOES NOT PRESUME TO GIVE <br /> ior n�acn o� AUTHORIiV TO VIOIATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAl'f REGULATING CCNSTRUCTION 06 TME <br /> PEFlFORM1IANCE OF CONSTRUCTION.THAT I AM A1ITHORIZF.�BY THE <br /> OWNEP OF THIS PROPERTV TO PEHFORM THE WORK FOR WMICH <br /> APPLICATION IS MAOE AND I COMPLY WITH TNE STATE <br /> v�nc[�rAriormueca CONTPA 10RSLAW1B27R WAND296200WAC. <br /> LONSiPUCiIONLOANLENOEP.ADCRE55.iELEFN@1ENUM9cP X`\ .�/�� , ���C����� �r/��/—� <br /> — S�GIIIJ�1[ O�¢ /� <br /> CITV OIISiN[55 LICEf15[NO <br /> PLUMBINf. MECHANICAL <br /> NO. TVPE OF FI%TURE ON ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER ClOSET�TOILET� NC—A'MND�G UNITS <br /> BFTHTUB FORCFD AIR SYSTEMS <br /> LAVATOFY�WASH BASIN) HEATPUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINN 8 DISP CLOTHFS DRVERS <br /> DISHIYASHER RANCoE HOOD <br /> LAUNDRVTRAY WATER HEATER <br /> CLOTHES WASMER WOOD STOVE <br /> URINFL METAL FIREPLACE(WOOD BURNING� <br /> DPINKING FOUNTAIN FIqEPLACE INSERT(WOOD BURNING� <br /> FLOOR DRAIN GAS FIREPLACE <br /> BACKFLOw PREVENTERS GAS PANGE <br /> SINK�SERVICE—BAR,ETC.) GFS PIPMG i <br /> E%NAUSTFAN <br /> SUBTOTAL 5 SUBTOTAL 5 I <br /> PERlAIi 5 PERMIT 5 <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> �POt1i5EiB�CN PE�PSEiO�CK S��E'iEiB�LN FUNCMECNNOMBEP iEE PECEIVTNO <br /> uscxa��e �o*�e¢� wuHrsi*e FEES VALUPTION FEE <br /> ❑vE5 �MO BWLOINO <br /> NEiOnitIMR.UpN NOOFpnRLINO 54EOfBLCGT <br /> px115 P�UP9PK <br /> CCCI1�AIiCY h9R51CaE5 CCWVANi(0�0 B�SEMEN� MECN�N:LAL <br /> cAwv <br /> nres ❑r+o T— <br /> FlRESFRMNLEPRE00 PE�SON �OOIi1JW'PLANCIIECK 1 <br /> OtNEN — I _— <br /> RRE�U��4REOD AEASON <br /> SU1E BW W�NG SvflLNMGE <br /> rvac cr corvs*. vw�s�vvAoveo er CITY OF EVERE7T i�eucwonns <br /> LOCALSALES <br /> o�re TAX CO�E IS 3105 TOTAL <br />