Laserfiche WebLink
APPLICATI�i�I FOR CONSTRUC1.bN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f�' <br />❑ DEMOLITION fl COMBINATION BUILDING C7 MECHANICAL f� PLUMBING fl SIGN <br />PROJECT ADDRESS <br />o c�/ I-� � h�� l� f�'✓E <br />ONMER MAIL�DDRESS LITY 21P PHONE <br />JU�� -1� l>�-ACf'� -:S�G � 1-I C��� n- fh/� 6'r�..:=-rr t�� ryJ'Zo� 3 3� _�1J' 7,� <br />tENANT MAILAODRESS Cltt 21P PlIONE <br />ARCHITECT OR OESIGNER <br />`v��n/ t <br />MAIL ADURE55 <br />[1N7Yt <br />�A�S 1651I <br />IIf� PMIJNE <br />Z �L�7�s_IjiJP110NE <br />�`� L,y,il�✓,NOcD wA <br />ZIP P��ONE <br />UCENSE/ <br />. <br />PLUMBINO CONTRAf,TOR MAILADDRESS CITY ZIP PHONE STATE LICENSE � <br />OESCRIBEWORK�NDSOUAREFOOT�GEINVOWED ^�� <br />_ , F}i���!'174�/ ,, o� f� 0�� <br />s�-f£ %t�o r.: J�`� r.oA�D �I�G Ac�cK <br />288 S,r, � Ta �x/Sn�� �� �/ L <br />PROPOSED USE OF BUILOINO <br />co�/c5f� o✓� i.�7/bi�/G vc��;�C <br />IEO�I OESCRIPTION OF PiIOPE <br />LOT BLOCK <br />� PMCEL TiVI I.U1NMBi � b�{, v ��- O <br />( (� <br />' CONSTRUCTON LOAN IENDER, A�ORE55.7ELEPHONE NIIMBEN <br />PLUMBIN(i <br />NO. TYPE OF fl%TURE OA ITEM <br />�� WATER CLOSET (TOILETI <br />; � LAVATORY(WASH BA'. <br />' SHOWER <br />� KITCHEN SINK d DISP <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. ET <br />FOH OFFICE USE ONLY: <br />FRONTSETB�CN PEAR SETORCK <br />USEZONE�_ / LOTAREA <br />NEIOMT <br />FIRE MARrM �REO D <br />I�l� <br />FIRE SPRINK,I�E`R REO <br />IVV <br />TVPE OF CONST <br />�N <br />SUB TOThL S <br />PERMIT S <br />TOTAL FEE E <br />NO.O: DWEWNG <br />/ UN175 <br />S�OE $ETBACK <br />FEE <br />VpCANT SITE <br />f1YE5 fl NO <br />S�IE OF BLOGRI. <br />❑YES fl NO <br />CRY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />HEATING SYSTEM: ❑ GAS O ELECTRIC ❑ <br />CONTACT PERSONAND PMONE NO S /, .. � <br />(� S �—t7r7' � <br />7`i3 - /56S <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPUCATION AND KNOW THE SAME TO BE TRUE AN� CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINA! �CES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WF'ETHER SPECIFIED HEREIN OFi <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I Mf AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 qQW AND 296200 WAC. <br />NO. <br />NO. TYPE OF Fll(TURE OR ITEM <br />A/C —MiNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. I <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DHYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WOOD STOVE <br />METAL FIREPLACE I <br />FIREPLACE INSERT <br />GAS RANGE <br />GAS PIPING <br />E:'HAUST FAN <br />o�rE ' <br />TOTAL S <br />NIT $ <br />PUNCHE�CN/N?MBER / I FEE w�. n` I RECEIPTNO. <br />`CJ �� O V <br />BUILDING <br />PIUTABING <br />MECMANICRI <br />AD0190NA1. PLAN CMECN <br />OTHER <br />STATE OUIL�ING SURCNApGE <br />POBUC WORKS <br />TOTAL <br />� <br />