Laserfiche WebLink
_ � <br />APPLICATIO.� FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />❑ DEMOLITION ❑ COMBINATION fl BUILDING I_l MECHANICAL ❑ PLUMBING ❑ SION <br />PROJECT ADDRESS <br />�� ao � <br />ONTlF.R MMLADDRESS <br />`����Q. a�vQtoPCm��� �r <br />TENAN MRILAODPESS <br />�OJ� �u � -, <br />� <br />�ti �o t�n <br />CITV 21P <br />�N(:MntGl VRUtJit.ntH M/(4AUUNt55 V CIIY 21P PNpNE <br />GENER�L CONiH�CTOR� M�IL AD�RE55 CITV 21P PHONE STATE LICENSE � <br />PlU6BING CONiR�CTOR M�IUDORESS <br />OE$CRIBE WOi1K ANO SOUARE FOOT�GE INVOLVEO <br />CITY ZIP PNONE $TATC IICENSE � <br />�ac�.h ��.Q���.�o a�o33 �g- y�uo <br />Cltt ZIP PHONE STATE LICENSE � <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ _ <br />CON7�CT PERSON AND PHONE NO <br />LEOAL OESCPoPTION OF PROPENTY �SHOWN BELOW OR �R�CH iVIO COPIES) <br />wt e�ocK _ oF <br />CONSTRUCTION LO�N LENDER. ADDRE55, TELER�ONE NIIMBER <br />PLUMBINO <br />NO. TYPE OF FlI(TURE OR ITEM <br />WATER CLOSET (TOILE� <br />BATHTUB <br />IAVATORV (WASH BASIN) <br />SHOWER __ <br />KITCHEN SINK S DISP <br />DISHWASHER <br />UUNDRY TRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />PERMIT $ <br />TOTALPEE E <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVIStONS OF LAWS AND ORDINANCES GOVERNINO THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEFiEIN OR <br />NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO QIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW RE6ULATINp CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOHIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br />y�r �._.�o.,v. � S'9 S <br />SIONATURE DATE <br />CITV BUSINE55 LICENSE N0. <br />MECHANICAL <br />TYPE OF flIITURE OR ITEM <br />A/C — AMNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />UNIT HEATERS — B.T <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOODSTOVE <br />GAS FIREPLACE <br />OAS RANGE <br />PERMIT 5 <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SET3ACN REAR SETMCN SIDE SETB�CK PIAN CMECK NUMPER FEE PECEIP7 NO. <br />�� <br />USE ZONE LO'! AREA V�CANT SITE FEES VALUATION I <br />❑YES ❑ NO BUILDING <br />HEIOHTLIMITATION NJ.OFDWELUNG SI2EOFBLDGR.1. <br />uNITS <br />OCCUPAN(Y <br />GROUP <br />OF CONST <br />PWMBINC+ <br />15EMENT MECHqNICAL <br />❑YES fl NO <br />ADDITON�L 7LAN CNEGK <br />OTNEfi <br />ST�TE BUILDING SURCN�RCE <br />CITY OF EVERE7T PUBLIC WORKS <br />LOCALSALES — <br />TAX CODE IS 3105 TOTAL <br />