Laserfiche WebLink
APPLICAT�ON FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> (l DEMOLITION ( 1 COMBINATION f� BUILDING I-1 MECHANICAL f 1 P�UMBING �SIGN <br /> PROJECT ADDRESS <br /> �3Z ����rm����Qi <br /> OWNER MAILAO�PE55 CITV ZIP PNONE <br /> '�d=.l��T�1 l��tt�e�h�, z3? 4- Lc.1m Ihr�r� �."� ��SZO I <br /> IENANT MAILADOPE55 CITV TIP PIIONE <br /> ARCNITCCT OR OESIGNER MAII AD�RES$ CITY pIP PHONE <br /> GENEP�ICONTRAGiOR MAILAODRESS CIIY ZiP PNONE SIATELICEKSE• <br /> Jil-.v5 Pr� t�l�lSrkAU, Zt2 C-=,,T Av{_ �✓e�cTr wA �'+BZc� ZS�i-�sai S/E,N "Rn� O55�o <br /> MECH�NICALCONTFACTOR MAILAODRES$ CIN 71P PIIJNE STFTELICENSE� <br /> PLIIAIBINGCONTRpCTOP MaILA�ORESS GIN 21P PHONE STATEUCENSE� <br /> GONTpACT PRICE OF WORK � � � <br /> �IGO HEATING SYSTEM: f l GAS f-1 ELECTRIC f� <br /> OESCRIBE WORK PNO$OUnRE FOOTAGE INVOLVED CONTACT PERSON ANO t+110NE NO <br /> 1-�G F�DY6 Z�i�l - ��0 � <br /> ���-�� a �e.� S, � <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXl,MINED THIS <br /> PPOPOSEO US[OF PUILOINC� 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 /> LEGAL UESCRIPTION OF PRpPERTY(SHOWN BELOW OR ATfACH TWO COPIES) NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOM OF ANY <br /> OTHER STATE CR LOCAL LAW REGULAI"ING 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 /> PARCEL TA%I.D.NUMBER CONTR CTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTIONLOANLEN�ER.AD�RESi.TELEPMONENUMBER x _ �-� , — ' � <br /> SIGNATUR DATE <br /> CITV dU51NE55 LICEN°c N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BAS�N) � HEAT PUMP � <br /> � <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY ; RANGE HOOD ' <br /> CLOTHES WASHER � WATER HEATER �- <br /> URINAL ' WOOD STGVE <br /> DRINKINC FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS fIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> ; GAS PIPING ; <br /> � EXHAUST FAN � <br /> � i <br /> SUB TOTAL S ; SUB TOTAL $ ; <br /> PEPMIT S i PERMIT $ � <br /> —� <br /> TOTALFEE 5 TOTALFEE 3 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETAACK RE�fI SfT9ACN SIDE SETBACit PLAN CIIECK NUhI�[R FEF �/� RECEIP7 NO. <br /> l % ��//� / t _. _ <br /> USE�'1�� ^7 AREA VACANi51iE FEES VALUATION FEE <br /> — Ci N � � � ��VES � pUILOING ��L � <br /> i <br /> FF1EIGHTUMITATION NO.OFOWELIJNG SQEOFOIDGT � <br /> �1IXF`�ar � UNIiS / {+�UMAING � <br /> I � <br /> OGCUPANGY NO Oi SiORiES OGGUPANT IOAp BASEMENi MF.CH4NIC�L � <br /> GfiOUP � <br /> IlYF.S I1 NO <br /> FIREALAiiMREOD Pf-ASON AODIIIONAI.PLANGIF.GN <br /> �— <br /> OiMER <br /> FIRF SPPINKIER RF.OD RF�SON i <br /> STN E BI pL�ING SURCIInRGE i'j�� <br /> �.0�i <br /> tvrForr.oNsr r�nNsnrr qvFosv CITYOFEVERETT runur.wonKs I_ <br /> � LOCALSALES <br /> uaTE �,- TAX CODE IS 3105 707AL �_�� <br />