Laserfiche WebLink
ARPLICATIOrI FOR CONSTRUCT��N PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 9FS201 • (425) 257-88 i 0 <br /> ❑ DEMOLITION ❑ COMBINATlON ❑ BU-ILIDING ,�u MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: �l'i I� I-� ��`�`� LI V E � 1�"ti�� � �'( � (` I <br /> OWNER MRIL��DqE55 LIN ZIP PNONE <br /> �- TC ���� r�E ��l �o� �l �-lo�l -r � �! �`( -�KzUi z�G -�( �`� <br /> TEN�Nt 1.INLN�DRE55 GTY IIP PHONE <br /> yy�•�y�.��. % <br /> nAC" Hli[c�0E51� M�II AppqE55��C �iry Iip <br /> !'HONF <br /> G NEf1AlCONT CTOfi MAqA0DRE55 CIIY IiP Pup4E SfAIELICEIlSE� <br /> MF.CNR��7 qCT0�E55 ����, �'��'`����It'�l� `���P110 E �1� �'�ICE 5�'O�� <br /> Z� � -����� <br /> PIUMBINGCOMRAfTOR MAILqWRE55 LITY 21P PHONE $TATELICENSE� <br /> COI1fRACi PRICE OF WORK ,..,/ <br /> '� � � —' HEATING SYSTEM: .Cl GAS ❑ ELECTRIC ❑ <br /> �ESCRIBE WOFK ANp SOUAPE FOOT�GE INVOLVED CONTACT PERSON pN0 f'HONE NO <br /> L' E 0 E_ <br /> CS � a Z Z-�1 <br /> t HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> cAoaosEo usE oF eui�oiric — APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br /> PFiOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WI�L BE COMPLIED WITH WHEI'HER SPECIFIED HEREIN OR <br /> LEGALOESCP'PTIONOFPROPERtt�SMOWNBELOWORAifpGMTWOCOPIE51 NOi. THE GRANTING OF A PERMIT L'OES NOT PRESUME TO GIVE <br /> ior OLOCN or AUTHOPITY TO VIOLATE OR CANCE:L THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW REGUVQING CONSTRUCTION OR THE <br /> PER�ORMANCE OF CONSTRUCTION.74AT I r1M AUTHORIZED 6 THE <br /> OWNER OF THIS PROPERTY TO PERFURM THE WORK FOR WHICH <br /> APPLICATION IS MAD , �OMPLY WITH THE STATE <br /> PARCFLTA o uABER y��rr,����U�v� CONTRACTORSLAWI . 7 APD 96200WAC. <br /> V � / � <br /> CONSTHUG ION IOAN IEN�ER.AODAESS.TELEPHONE NUMBEP x �� <br /> SIGNRTUFE DRi[ <br /> r�TY BVSIllESS LICCNS[t:q —' -- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EpU�PMEMT FEE <br /> WATER CLOSET(TOILET) � A/C—AMN�IG U!JITS � <br /> BATHTUB ; I FORCED AIR SYSTEMS ' <br /> LAVATORY(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNITHEATERS <br /> KITCHEN SINK 8 DISP � i CLOTHES DRYERS � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV � WATER HEATER ' <br /> CLOTHES WASHER � WOODSTOVE , <br /> URINAL � METAL FIREPLACE(WOOD BURNING) <br /> ORINKING FOUNTAIN � FIREPLACE INSERT(WOOD BURNING) <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS RANGE ' � <br /> SINK(SERVICE—BAR, ETC.) GAS PIPING <br /> � EXHAUSTFAN � <br /> i <br /> i � <br /> i i <br /> SUB TOTAL S ; SUB TOTAL $ ' 1 <br /> PERMIT $ � PERMIT $ i <br /> TOTAL FEE E ' TOTAL FEE $ � <br /> FOR oFFICE t1SE ONLY: <br /> FRONTSFTBRCK RFAPSF.iBRCK SIOESElB�GN PUN�IIELRNUMH[R �EF �fCE�PTNO <br /> use zoNF 101 RRER VRGANT SIIE FEES VALUATION FEE <br /> _ ❑ves ❑ uo nunniNc <br /> HEIGNi IIMItAT10N NO.OF LWELLING 512E 0�BLDGRI — <br /> UNIIS <br /> PlUM91NG <br /> . —__-- _.�_ <br /> OCCl1P�NCY NO04SIOniFS IX:CUPANllUAO ORSFMENI MFG1nNiCAI <br /> GPOUP <br /> ❑YES ❑ N7 __ _ _'_ <br /> FIRESPBINNLEfiPEOD �FRSON ADDIIIONALPIAN�Nff,N <br /> _ �_ <br /> 0111E� <br /> FIREAI�IRM1IRE4'0 RFASOV � <br /> SiAI[p111lUING SUfiCHAqGE <br /> irvearr,o�+sr rinNsnrrnoveoov CITYG'FEVERETT <br /> rllqi�f,wnPNC <br /> LOCAL SALES -- -- --- — - <br /> onte TAX CODE IS 3105 TOTAL !— <br /> — -- —`— <br />