Laserfiche WebLink
� � <br />APPLICATIOnI FOR CO�ISTRUCT�Ot� PERMIT/ <br />CITY OF EVERETT • BUILDING DIVISION L�C� <br />3200 CECIAR STREET • EVERETT, WA 98201 • 259-8810 � <br />(! DEMOLITION f 1 COMBINATION f l BUILDING I 1 MECHANfCAL xi PLUMBING I I SIGN <br />PROJECT ADDRESS <br />,/��� � S /-1,� �/ % 2 i/ f 1 <br />owNen IAAIL 4D�Rf:S$ arv nr r�a�r�e � -- <br />��brP� ��il�y�'��A�le;�, oz���3-�r'1 _ <br />1[NRNT uni� poncs, eirv im n�oev- — <br />PRLIIITFC70P pE51GY[R MAII AODRE'=5 CITY IiP PIION[ <br />GF.NERALCL4iq4C.Of1 MAILnDORf55 fllY ZIP PIION[ ;,�RL[IICFYE4� <br />NECHANICpLCON1RACTOP NAi.�DDRESS <br />PLUMBINGCONiRAf.:OR ldAlLnDpRESS <br />CONLRACT <br />OC:SCRIOF WORKAN9501IA�iE FOOTAGE INVOLVED <br />PROFOSF.D lISE OF BUIlDR1G <br />LEGAL OESGRIPifON OF PROPI <br />im- e�o:.rc <br />PqACEL <br />R7i <br />CITY <br />CONiTRIICTION tORN I.EN�ER, AD�RE$S. TF.LEPIIONE NUM�ER <br />PLUMBING <br />NU. TYPE OF FIXTURE OR <br />� WATER CLOSET (TOILET) <br />FJATHTUB <br />LAV�TORY(WASH BASIN) <br />SHOWER <br />KITGHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTFAV <br />CLOTHES Wi1SHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />SINi( (SERVICC — BAR, <br />Itl�� <br />SUB TOTA� $ <br />PERMIT 5 <br />TOTAL F�E S <br />FOR OFFICE ii:;E ONLY: <br />rr,oNTSFmncK nEnncernncK <br />USEIONE IfOTAB[A <br />HEIGIR LIMITATION NO OF UWLLLING <br />IINIiS <br />OCGI)PANCY NO Ot cI0a�E5 OCCUPnNi LpAD <br />Gnour <br />FlRE/LFRMREOD PPA50Y <br />fIRF$PRINKIFRPFO(] fiFA�ON <br />nnie <br />soE sernncK <br />,'IP PIION[ ciA1F I IC[NcF • <br />SiAiEI.ICENSE• <br />HEAl'ING SYSTEM: f I GAS f i ELECTRIC f 1_ <br />ca�rnc�rgso�+nrkr�ioNs U 3 � `T 7Y(.� <br />���' �Z - ��/� �i '' <br />I HEREBV CEfiTIF� 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 GOVEFiNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIF!E� HEREIN OR <br />NOT. THE GRANTING OF A PERMIT GOES NOT PRESUMF: TO GIVE <br />AUTHORITY TO ��IOLATE OR CANCEL THE PROVISIOP! OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CUNSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS �d4DE AND I COMPLY Wf�H THE STATE <br />CONTRACTOHS LAW 18.27 RCW AND 296.200 WAC. <br />x � c ��_�� — <br />SIGNRIURE 0/�[ <br />:ITY OUSME55 LICFNS@ NO � <br />NO. TYPEOFE�UIPMENT FEE <br />A/C—A/HNDLG UNITS—H.P. <br />FORCED RIR SYSTEMS — 9.iU. M E.A. <br />HEAT PUMP <br />UIJIT HEATERS — B.T.U. M <br />CLOTHE�S DHYERS <br />VENTILATION FAN <br />RANGEHOOD <br />�NATER FIEATGR <br />N'OOD STOVE <br />METAL FIREPLACE (WOOD �URNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GAS R.ANGE <br />GAS PIF`ING <br />! �nuS'; FAPI <br />SUB TOTAL "a <br />PERMIT 5 <br />TOTALFEE 5 <br />rinNcnccHruur.mcn �rcc �nrr.Fmtuo <br />VaCA�J�51/F htt5 _ <br />I iY[5 I�� NO �pILDMG <br />c17f. OF A� IH:R I <br />1'111M01NG <br />Ef�<EMENL MF.C�IANiCAI <br />ilYES II NO <br />A�PIIIpN01 PLANCHECN <br />0111Ef: <br />Sin1B 011RUiNG SU9CUGfiGE <br />CITY OP EVERETT ri�nnr, wonKs <br />LOCALSALES <br />TAX CODE IS 3105 TaTA� <br />