Laserfiche WebLink
APPLICATIVA FOR CONSTRUC? �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> fl DEMOLITION Il COMBINATION BUILDING I-1 MECHANICAL �1 pLUMBING f� SIGN <br /> PROJECT ADDRESS <br /> ,�I //3 � �rati.-L <br /> OWNER MAILADDRE55 CIIY 21P PHON[ <br /> Fe�ICe� 'tol, Z1 � 3 E• G�<�.-�J� L-var� {� GYa-o i <br /> IENANT MMLADDAF55 f.ITY ZIP VNONE <br /> �F.CHITECTORUESIGN[� fd�I1./�DORE55 GTY Zli' PHONE <br /> C l� s/� �9',a� we �.s+o� Y�u��a f� 9 Fl�v� o�s�!-�7 3 S <br /> GENEMLCONTRnC70R MAIIA�URE55 CIIY i.IP PNOYE GiATEIICENSE� <br /> �el.eo� C' s�w,.. 1-�0,�..�5 r�oi-orcMF u��w �C�. L✓zirlf 4S�?o3 3u7/S�Sl ,l�LPO��t /S6.T/'� <br /> MECHANICAICONTRACiOR MRILADDRE55 Cltt ZIP PIIONE $TA7ELICENSE� <br /> PLUMBING CONTR�CTOR MAII.AODRE55 dTY�/ 21P PHONE SUTE UCF.NSE• <br /> �/G W �c �n n �Ciy TT 3 3 7 b0 6 <br /> CONTR�CT PRI E OF K o� <br /> 3 5 ooQ HEATINC SYSTEM: f l GAS rl ELECTRIC I� _ <br /> OESCRIBE Vd7RK�NO S UARE FOOTRGE INVOWEO /� CONTACT PEPSON AND PNOI+E ND. <br /> Sa 4w� 1 LuJ �00'Y ��� <br /> lx- <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> r 5• WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br /> �ecaoes ianoaoFar+orenrrls'rovmeetowoHnn�cnTwocoaies� � NOT. THF. GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iot 3 eiocK � oF ��+ '�'^��s � � � :d AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> TD EU�lt� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CCMPLY WITH THE STATE <br /> PARCEL TN(I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> a�z 9os - � 003 -0000 x '��_� L� ��s�ss� <br /> CONSTPUCTON L6AN LENDE0.ADORE55.TELEPMONE NUMBER <br /> 'Z �jf �j� SIGNATURE OATE <br /> CIiY BUSINrSS UCENSC N0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TVPE OF EGUIPMENT FEE <br /> WATERCLOSET�TOILET) j � A/C—A/HNOLGUNi—H.P. ' <br /> BATHTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A, ; <br /> Z. LAVATORY(WASH BASIN) // � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAV ; RANGE HOOD � <br /> CLOTNES WASHER � WATER HEATER � <br /> URINAi_ ' WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS � GAS FIREP�ACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE <br /> i�„�y GAS PIP�NG ' <br /> � EXHAUST FAN � <br /> � ' <br /> SUB TOTAL $ ; SUB TOTAL $ ; <br /> PERM�T S � PERMIT $ � <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: P �r i��:�-. <br /> FRONT SETP�CN REAR SFTAALR �( ` SIOE SETB�CN !'lAN QIECK NUM9[R fEE �F.CFIPT NO. <br /> �j' rj "Cae_C�1G �:O <br /> useior+e ro{ iornnen VRCAMSIiE FEES VALUATION FEE <br /> _ _L ��j.. nvEs +o ouun�Nc �$ h65 � — <br /> MEIGNT LIMIi�T10N NO OF UWEIUNG SIZE OF BLOfT <br /> I UNIiS PIUA!flINO <br /> 3 o s� r�b �rv - �3��— <br /> OCCUPANCV NO Ot SfORIES OCCUPpNT LOAO BRSEMENT _, NO MGOIANIC4l / ' <br /> GROUP / __L_� : __ <br /> 3 �_ w / <br /> FIPEALARMREOD fiGA50N AODIIIONnLPI�NCHf.CN / �� <br /> __! <br /> O1RER <br /> FIRFSPRINKLERREOD RF�SON <br /> STAI[DUitUMf.5VRC11Rflf.E : �S/1 <br /> �`..!� <br /> trre or r,or+st rinNsarr�jov o ar CITY OF EVERETT runnc wonKs ' <br /> .�_� V I� LOCAL SALES �� <br /> uAiE �O�Z L� S TAX CODE IS 3105 TOTAL <br />