Laserfiche WebLink
--• ,_ <br /> APPLICATI�.�1 FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVE:iETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET•EVERETT, WA 98201 •259-8810 <br /> fl DEMOLITION fl COMBINATION f�BUILDING f� MECHANICAL rl PLUMBING fl SIGN <br /> PRWECT ADnRESS <br /> ,�-IG';� ��'�� �`;r <br /> ��R MML11DpiE55 CITY IIP tHONE <br /> �P<C'.���Z�2 �ICF� C P��r�r� C?itl'� iJ.� ��'?C�l ,��i'- 2Soj <br /> TEN�NT MNL�DDRESS qTy Z�P <br /> PNONE <br /> .�J/�"7"11Cr �/^i'`� <br /> ARpMTECTpqpESIGNEq M�ILAOIXiE55 GITV 21P PHONF <br /> �yi� " w� <br /> C+ENEP�LCONiR�GTIXi MAILADDRE55 pTY 71P PIIONE STI1iEIICENSE� <br /> MECH�NICALCONTRA�TOR M�IL�OD{IE55 QTV ZIP C110NE ;,IRTEUC[NSE� <br /> MUMBMG CON7R11CTOR M�ILADpqESS LITY ZIP PHONE STATE UCENSE� <br /> conra�cr rn�a�wam <br /> �-Ca'�.°C-� HEATING SYSTEM• fl GAS fl ELECTRIC f-I <br /> OESCRIBE Y/Opl(ANO Sq1ARE FOpT/�GE INVOLVEO CONT�Ci PERSON AND F110NF NO. <br /> �jZ LW�.,E !w � <br /> .t3ack rZzrc�. +1�2 �lpctie ac�.e_�. rv gtrsi-n�o„ . <br /> I HEREBV CERTIFV THAT I HAVE READ AND EXAMiNED THIS <br /> vnorosEo usE ov euadrq APPLICA'i ION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �/'7� PROVISIONS OF LAWS AND ORDINANCES GOVERMPiG THIS TVPE OF <br /> tEo�ioescmrnor�oFPnoreqrr�yqvme�ip�ypq�n,�Hnypcov�esi WORK WILL BE COMPLIED WITH WHETHER SPECIFIED NEREIN Ofi <br /> NOT. THE (iRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior e�oac � AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW HEGUUTIN6 f;ONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK fOR WHICH <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> P�cE�i�z i . CONTRACTORS LAW iB27 RCW AND 296200 WqC. <br /> . � 6� �J /7 <br /> CONSiRUC11p111OAN LENDEP.1100RE55.TElEP1qNE NUdBEq X / _.��_�� <br /> / <br /> SIGN�TURE OAiE <br /> Clry BVSINESS LICENSE NC. <br /> ���� MECHANICAL <br /> NO. T1'PE OF FlIfTURE OR ITEM FEE NO. T'PE OF EOUIPMENT fEE <br /> WATERCLOSET(TOILET� � NC-qry{7��pUNITS-M.P. � <br /> BATHTUB � FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> LAVATORV(WASH BASIN) � HEAT PUMP , <br /> SHOWER � UNITHEATERS-B.T.U. M � <br /> KITCHEN SINK 6 DISP � CLOTHES DRYEHS ' <br /> DISHWASHER . , � <br /> VENTILATION FAN , <br /> UUNDHY TRAV ; RADt6t HOOD � <br /> � <br /> CLOTHES WASHER r WATER HEATER , <br /> URINAL ' WOOD STOVE � <br /> DRINKIN6 FOUNTAIN � METAL FIREPLACE(WOOU BURNING) ; <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PqEVENTERS ; GAS FIREPLACE � <br /> SINK(SERVICE-BAR,ETC.) GAS RANGE , <br /> GAS P�PING � <br /> � EXHAUSTFAN , <br /> _ , �— <br /> i <br /> � � <br /> � <br /> � � <br /> SUB TOTAL S � SUB TOTAL S ' <br /> �£9MIT S � PERMIT S , <br /> _ _ TOTAI_FEE S � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> Fi10NT SETPRCK RE�P SFTBALK SIDE SETB�CN PIAN CHECK N AER FEE REf.EIPT NO. <br /> �� 7 <br /> usezot+e 10711RE� vnc�Nrsite FEES VALUATION FEE <br /> I1YE5 li NO q —� <br /> — �uuniNr, 1JT�J � � <br /> HEIGIIT LIMIT�TION NO OF UWF.LtING SIZE OF BLIX;rtI � <br /> UNIIS i-- <br /> S� S,F P���Mf11NG � <br /> GC�COP�NCY yp pf SIOPIES OCCUPRNT LO�O BASEMENT � � M[CH�MCaL � <br /> � ' /V IlYES fWiO -- — � <br /> FlRE AL�RM REO'0 N[ASON Ap�I11pNM.P14N CNf.CN � <br /> OtH[R � <br /> i <br /> FlRFSPRINI(IERREOD qFA�pN � <br /> STpiF.011ILDING SIIRCHRqGE <br /> TYPEOFf,ONST r'I�NS�PPROVEfJflY � <br /> J.� CITV OF EVERETT runnc wonKs <br /> -�7� ��'h' LOCAL SALES -%— <br /> �L- �(./ onTe �.5 - TAX CODE IS 3105 70TAL <br />