Laserfiche WebLink
APPLICAT14rd FOR CONSTRUCTION PERMlT/ <br />CITY OF EVERETT • BUILDING DIVISION �!C� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 � <br />rl DEMOLITION pZ COMBINATION � BUILDING �Z MECHANICAL J� PLUMBING t� SIGN <br />PROJECT ADDRESS ,l <br />� � 7 �Ccr/Yti'i� U�IV� <br />OIYNER M4i�qDORE55 <br />C11V Z�P PHpNE <br />l�ne 4Jh���h�.�.l� '1r� �,�:�1 l�r. C�c�f" � oJ <br />, � as�- y�i3 <br />TENA`NT IAAII)ADUPE55 C�Tv ZIP i'HONE <br />• �'m'�� L[5 c. ,/�}7JC <br />ARGHrtf.CTORpE51GNER MAi�qD�PE55 Cltt )iP PHO'.E <br />�� <br />GENERAI GONiRACTOR IAAILpDDRE55 QiV jIP pHONE cTAtE LIC[NSE • <br />�L�/Sfh Pc..s� I S5'�'� `.! Sn,�/wnad� 1F 101 DH <br />a3 s�. .uc. �1�P.�90 33�I-7J�3 t�l,�s�c - <br />MECHANI�AL CONTRACTOR ldAq qpDPE55 CITY )ip PIIOkE cTATE IICEKSE • <br />�C..i[�t �ivi o'r / S.{'U.2 oi3� Si AX- '� iie,,,c L, C.� P�4n �?��i�77 7? ; n.�rc� ��_. .. � � <br />' PRICE OF WORK <br />T1/ <br />YlOFK AND SOURRE <br />IEGR� pESCRIPiION OF PROPE�TY <br />LOT H� 5 BLOCK QL <br />ZIP PMOtiE cTAiE LICENSF • <br />= u, r, .,,� �, �� �•� S - �7 � -+- /.23gD <br />^d, `�r HEATING SYSTFM: �GAS �� ELECTRIC jd�:�� <br />INVOLVED ,,, CONiACT PER50N �N� PHONF. N0 <br />OR AITACH 1 WO COPIES� <br />PAPGE[TA%ID.NUMBER <br />S�cl�l —O/O— OOy—O <br />GONSTqUCPONIOAN�ENOER.A�ORESS.TELEPNONE NIIMBEq <br />PLUMBING <br />N0. TYPE OF FI%TURE OR ITEM <br />WATER CLOSET ITOILETI <br />LAVATORV(WqS <br />SHOWER <br />KITCHEN SINK & <br />WASHER <br />ORINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAFl, ET <br />SUB TOTAL 5 <br />F'ERMIT 5 <br />'OTAL FEE $ <br />FOR OFFICE USE ONLY: <br />fPONTFFTFlACN REAR SFTARCN SIpESEiBaLK <br />USF. 20NF <br />HEIGIIi LIMIiaTION <br />OGCUPANCV I NO 0� SIOPiFS <br />cnour <br />tYf'E <br />� <br />FEE <br />I HEREBY CERTIFV THAT I HAVE REAO AND EKAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRI;E AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED W!TH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THc PROVISION OF ANV <br />OTHER STATE OR LOCAL LAW REGIILATING CONSTRUCTION OR THE <br />PEflFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPFRTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />�CONTRACTORS LAW 1827 RCW 0:D 296200 WHC. <br />x _ G�%���_1��%7?-..- / - ,� 9<v <br />^iGNATURE OFiE <br />CITY BUSWESS LICENS[ NO <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />— A/FiNULci UNITS — H.P. <br />.CEO AIR SYSTEMS — B T.U. M E.A. <br />UNITHEATERS—BT.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD I <br />FIREPLACEINSERT�WOOD <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />E%HAUST FAN <br />SUBTOTAL 5 <br />PEFMIT S <br />70TALFEE $ <br />PlNlf.��C�CK N-U�M�OfR'/ P[F RECFIPI NO <br />]W�T <br />IOIAREA yACRN151if. FEES <br />l�YES i' NO <br />owinn+r. <br />kp Of OWF.ILING SIZE OF BL�RI <br />O�AtS <br />PIUN.[IING <br />OGCIIPANiLOAp BASFMENT MECHANiCRL <br />I1YE5 11 NO <br />f1FA50Y ADUIIION�L PIAN CMECK <br />OiH[R <br />nFn�oa <br />ST�I[ PNtDiNC SURd�qRf,E <br />rim�savpnoveouv CITYOFEVERETT ruenr,wonKs <br />LOCALBALES <br />oniE TAX CODE IS 3105 TOTAL <br />U� <br />(�L� <br />