Laserfiche WebLink
APPLICATIO.� FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETf • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOUTION Cl COMBINATION fl BUILDING f] MECHANICAL � PLUMBING Cl SIGN <br />PROJECT ADDRESS 3 5�� C r�7 _Q <br />U� <br />cin zi� vnoNe <br />�Y�l/e 9�/03 _ 633 -�{000 <br />TENANT � MAIIADURE55 LITY i1P PHOrvE <br />ARCHIT[CTORUESIGNER MAILADDRF55 CITY ZIP �MO4E <br />/�REmiE-�2 �u��DE2s '�53�'/7,janP(. SW_ �Yn/n/�c,o�) �,.�A. l�KFm�ailu'7Zai <br />GENERRLCONTAACTOR MAILPDDRE55 GIN 21P ��PHONE �-' STATELICENSE/ <br />.5 L <br />MECNANICALCONTRACTOR MAILAD�RE55 CITY ZIP PIIONE STATEUCENSE� <br />PLUMBINGCONiFRCTOR MAILADDRE55 CIN 21P PHONE STATELICENSE/ <br />CONTR�Ci PRICE OF WORK <br />DESCRIBE WORK ANO SaIIPFE FOOTRGE INVOLyED <br />n �P �� �4.+ncf/✓ l�0on <br />� /I ! <br />k/ tc�iC.i �'Or eX i 5 f',•T <br />PR'NOSEO USE OF BUILDING <br />LEG�LDESCRIPTION OF PROPERTY (SHOWN BELOW ORATfPCH' <br />LOT BLOCN OF <br />PARCELTAXI.D.NUMBER <br />CONSTRUGTION LO�N LENDER. AODRESS. TELEPNONE NUMBER <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY (WASH BA'� <br />SHOWER <br />KITCHEN SINK 8 DISF <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />e 3 , d�r <br />COPIES) <br />HEATING SYSTEM: ❑ GAS �[ELECTRIC ❑ <br />GONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICAT�ON AN� KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTLiACTORS LAW 1827 RCW_AND 296200 WAC. <br />CItY BUSINE55 UCMSE NO. V <br />MECHANICAL <br />OR ITEM FEE NO. TYPE OF FIXTURE OR �TEM <br />� AIC—A/HNDLGUNITS—H.P. <br />� FORCED AIR SYSTEMS — B.T.U. I <br />, HEAT PUMP <br />� UNIT HEATERS — B.T.U. M <br />FOR OFFICE USE ONLY: <br />FRONTSEiBACN REAR SETPRCK <br />USE ZONE <br />HEIGHT LIMITPTION <br />NO <br />SUBTOTAL S <br />PERMIT 5 <br />TOTALFEE $ <br />SIDE SETBACK � PLAN <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLA( <br />FIREPLACE INSE <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />7 <br />LpTAREA �ACANTSITE �CW <br />f7YE5 fl NO BUILOING <br />NO.OFOWELUNG SIZEOFBLOGRI. <br />UNIT$ P�UMOING <br />OCCUPANTIOP� BASEMENT MECN�NICAL <br />❑VE$ CI NO <br />REASON A�OITIONAL PLAN CHECN <br />OTNER <br />REASON <br />STATE BWLDING SURCMARGE <br />PLANSAPPROVEOBY CITY OF EVERETT PUOLIC WORHS <br />LOCAL SALES <br />.,..� TAX CODE IS 3105 TOTAL <br />FEE <br />� ' J yC — <br />SUB TOTAL S <br />PERMIT $ <br />TOTAL FEE $ <br />RECEIPT NO. <br />