Laserfiche WebLink
., ^w <br />APPLICATIO�. FOR CONSTRUCTI.�N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SJGN <br />PROJECT ADDRESS <br />773o Qr�ti� r' <br />OWNER 1AAIL�DDHE55 CITY 21P PHONE <br />LY�E E,QL�NK J�o,BoXaad � �'ve��,�- ��aos ao� 3s's �Y�as <br />TEN�NT MNLADIXiE55 CITV IIP PHCNE <br />I� rnvnt <br />L�../ <br />6ENEMLCONTRACTOfi M�IIADDRE$$ CITV ZIP PM(JNE STATELIGENSEI <br />.'�+�lt /�3 dGV7'l�r'— <br />MEpIMIIGLCONiAACTOR MNL�DORE55 CIN ZIP PNONE SUTEUCENSE� <br />-��'.fi�vb �ls m avr� tg�-- <br />LOT <br />PLUMBIRU <br />BLOCN <br />TYPE OF FlI(TURE OR ITEM <br />BATHTUB <br />KITCHEN SINK 6 DISP <br />CIOTHES WASHER <br />URINAL <br />FLOOFi DRAIN <br />BACKFLOW PREVENTERS <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FRONf5ET8ACK REAR SETBACN <br />u� � <br />USE20NE LOT�REA <br />�-� %/, 5$ <br />MEI�HTl1MITATON NO.OFDWELUNO <br />..� p_ � UYITS , <br />N0. <br />TYPE <br />cm <br />Ii� <br />SIDE SETBACK <br />21P <br />HEATING SYSTEM: ❑ GAS <br />CONTACT PERSON AND PHONE NO. <br />ELECTRIC ❑ <br />I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED TtiIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES (30VERNINO THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE ORANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW RE6ULATINO CONSTRUCf ION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br />CONTRACTO�iS LAW 7 B27 RCW AND 296200 WAC. <br />��E �o� ��t7 (O on�e <br />GTY BUSINE55 LICEt�SE NO. <br />N0. TYPE OF flXTURE OR ITEM <br />AIC —AlH4DLQ UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />UNIT HEATERS — f <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE ( <br />FIREPLACEINSERT <br />GAS RANOE <br />GAS PIPINO <br />EXHAUSTFAN <br />5' //�10 `/.5 <br />vnc�nr s�re FEES <br />�VcS ❑ NO BUILDINO <br />�F eiocr.i. <br />i�/ Sf LNiN4+ p�UMBINa. <br />io waA4�. <br />BASEMENT MECH/NICAL <br />�VES NO <br />AGOITIONAL PLAN CMECK <br />OTHER <br />STATE BUILDING SURLNAPGE <br />CITY OF EVERETT NUBLIC WORYS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />FEE <br />SUB TOTAL S ; <br />PERMIT S � <br />--�-- <br />TOTALFEE S ' <br />FEE RECEIPTNO. <br />A UATION FEE <br />(05 OZ O I �C <br />��1.-� <br />OJ 1 liv� <br />�r' „ � ��ti� <br />( -� � C�L� <br />� <br />� I D', <br />