Laserfiche WebLink
� <br /> APPLICATIOI. FOR CONSTRUCTI, N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINl.TION ,� ❑ B'U/ILDING ❑/�E�C�HANICAL ❑ PLUMBING ❑ SIGN <br /> ROJE T ADDRE S• Cu�� f����v/L°� ��-�`''^"E' <br /> � �L�c� �w�- � .z �%� C.�,,,�� ���.������� 9���3 3s3-G ��'� <br /> ONRIER M�IL:� E55 Gltt zIP / PMONE <br /> 7ENANT MAIL�DDpE55 CITY 71P PIIONE <br /> ARLNITEGT OR OESiGNER M�II ADDRE55 Gltt 71P P110NE <br /> GEHERA GONiRAC70R MNl/�DDRESS CITY TIP PIIONE Sf�TE UCENSE� <br /> 4ECHANICAICONTR�CTOR MAILADd1E5S LITY ZIP P110NE STATEIILENSE� <br /> PLUMBINGCONTR�CTOii /� �IlA00RE5S Cltt ZiP PIqNE STATELICENSE� <br /> � / 7-' i � e T <br /> CONTMCT PpIGE OF VIOfIN � � <br /> HEATING SYSTEM: GAS ❑ EI_ECTRIC ❑ <br /> DESCiMBF�VIQRN AND 501/��p��p!)IOIV��s � LONTACT VERSON�NO PHONE NO <br /> �t�e� /��i� i / U in.1�S d <br /> �,Pe /ee • <br /> I HEREBY C�RTIFY THAT I HAVE READ AND EXAMINED THIS <br /> moroseo�se oF e�nta APPLICATION AND KNOW THE SAME TO PE TRUE AND CORRECT ALL <br /> ����^�� PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> /� WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> tEtsµoescwvnoNOFvnor¢nrv�sxowneeiowoq� �c twocori¢st NOT. THE ORANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT BLOLK oF AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHEH STATE OR LOCAL LAW RE6UUTIN6 CONSTRUCTION OR THE <br /> PEHFORMANCE 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 COMPLY WITH TNE STATE <br /> v�nctti r�z i.o.ruuaep CQy7AAGTURS,LAW,927 RCW AND 296200 WAC. <br /> ��� � <br /> CONSTRUCTION IOAN LENDER,�OdiE55.TElEP110NE NUAIBER �` ��� <br /> SIGNATUPE OATE <br /> CITY BUSINESS IICENSE NO <br /> PLUMBINO MECNANICAL <br /> NO. TYPE OF fl%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—MiNDLO UNfTS ' <br /> BATHTUB ; FORCEDAIRSYSTEMS ; <br /> UVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS ' <br /> KITCHEN SINK 6 DISP ; CIOTHES DRYERS � <br /> DISHWASHER � RANGEHOOD � <br /> UUNDRY TRAY ; WATER HEATER ; <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT(1NOOD BURNING) � <br /> FLOOR DRAIN � GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS ; GASRANGE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> ' EXHAUSTFAN ' <br /> i <br /> � � <br /> i � <br /> � SUBTOTAL S ; SUBTOTAL S ;�":�C� <br /> PERMIT S � PERMIT S �L-' <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> Fqp1T SETBACK REAq SF.TBACN SIDE SETB�CN �UN CIIECN NUMBER FEE G RFC.EIPi NO <br /> J <br /> USE ZONE lOT AREA VAGINT S�TE FEES VALUATION FEE <br /> ❑YES ❑ NO pl11LDINC � <br /> i <br /> NE16HT LIMI7ATION NO OC OWELIING SIZE OF BIDGR.I <br /> UNIfS 1'UIMBING � <br /> � <br /> OCCUPANCV NO(%SI[MtlFS OLCUP�Nf 10�0 BASEMENi i <br /> G�P A�ECHnNIC�L i <br /> ❑YES O NO - - � <br /> FIRESPRINKLERREOD NEASON �ODIIION�IPLANLHf.CK � i <br /> ----i-- <br /> OIHER <br /> FlREALMMREO'D pE�SpN � <br /> STAIE OUIIUINf.511f1C1U0GE � <br /> __ �— <br /> TYPEOFf.ONST PlANSAPCR0VE0BY CITYOFEVERETT �IIOIICWORKS � <br /> LOCAI SALES —"'— <br /> o�TE TAX CODE IS 3105 TOTAL <br />