Laserfiche WebLink
APPLICATIO�I FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-88t0 <br /> fl DEMOLITION fl COMBINATION `j�BiIILDING �; MECHANICAL �� PLUMBING f l SIGN <br /> PROJECT ADDRESS �� /O Q��S n,�,,� / ����� <br /> KvE� <br /> OYrt1ER MNL�ODi1E55 Gltt ZiP PIIONC <br /> LAtr�e,� �qno�rro�J �F3vS,�a"`�i�.s� �nu�ax! 9��.3,6 77�/a€8' <br /> TENAN� M�ILADpqE55 T CITY 21P i`NONE <br /> ARCHIiECT OR DESIGNER MML MDRE55 GITV ]IP nNONF <br /> GENERIILCONiMCTOq M�IIMORE55 GtY IIP P�ION[ FLAt[LIC[NSE� <br /> L�uvsnyM6uu,4 �7oy �o'-�sa sw Ly�wo�� ��o�,� 7�a-9�ov L�Nostir�e o�aou <br /> MELNANIC�LG NTP�CTOR M�ILADDRE55 dTV ZIF PUONE SiAt[VCENSE• <br /> PLUMBINGCONIR�C70R M�ILADpRE55 CIN ZIP PNONE STATFLICENSE� <br /> CONTPI�� OOO �K �/I <br /> � � HEATING SYSTEM: GAS �l ELECTRIC (1 <br /> DESCRIBE NqRK AND SOU�RE FOOTAGE INVp�VEO CONT��T PERSON AND PHONE <br /> /a�~tt N� �/ r,� ,trA�r�� 7ia-9 �oo <br /> us A�w �c, � �vo. <br /> I H'cREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> API�LICATION AND KNOW THE SAI�E TO BE TRUE AND CORRECT ALL <br /> rnoroseouseoFe�n�ar+c PROVISIONS OF LAWS AND OPDINANCES GOVERNING THlS TVPE OF <br /> s WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL�DESC�RI.P�f10yNOFPROPERTY($IqWNBELOWOR�TTACNTWOCOPIES� NO7. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GiVE <br /> ior�eiocK�ov AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> s f / OTHER STATE OR LOCAL LAW REGULATINQ CONSTRUCTION OR THE <br /> - Oj� �+ � 77 �(��y 1/ PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE <br /> OWNER OF THIS PRGPERTY TO PERFORM THE WORK FOR WHICH <br /> OkSL 7D APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> r �.o.mn�eEn CONTRACTORS LAW 1827 RCW D 296200 WAC. <br /> 3 — - — � Q q <br /> GON5711UCTION IO�N LENOER.�DOqE55.TELEP110NE NUMBER %� ID�jO// � <br /> SIGN�TOPE G�TE �— <br /> CITY BUSINFSS IICENSE NO <br /> PLUAASINO MECNANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM FEE NO. TYPE OP EQUIPMENT FEE <br /> WATER CLOSET(TOILE� /yC—AMNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK d DISP i CLOTHES DRYERS <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDRY TRAV ; RANGE HOOD ; <br /> CLOTHES WASMER � WATER HEATER <br /> URINAL WOOD STOVE <br /> DRINKINO FOUNTAIN METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINGJ � <br /> BACKFLOW PREVENTERS ; GAS FIREPLAGE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE � <br /> GAS PIPING <br /> EXHAUSTFAN i <br /> � <br /> � <br /> SUB TOTAL $ � SUB TOTAL $ <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE S ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fRONT SETP�CK REAR SF.TB�CN SIDE SETPnCK PUN CIIFCK N IMOPR �Gf , ^ AFCEIPi NO <br /> s �� <br /> useione ioT�ne� V�CRNISIiE FEES VALUATION FEE <br /> — 11YE5 I� NO BUILDMG S � — <br /> HEIGHT LIMITATION NO.OF UWEILIHG SIIE Of BLIX:�� <br /> UNIiS �,✓' /4 t'LUMOING i <br /> V { <br /> OCCUP�NCV NO pf 909R5 OCCUPANTLO4D BASCMENT M[QIRNiLRL � <br /> cnour <br /> I IVFS i O ' — i - <br /> FIREAL�RA�nEO'D REASO4 �DDi11pNPI.PLANCHCCk i <br /> �— <br /> OiHER —I' <br /> FIRFSPR�Nq.ERPEOD RpA504 ��-- <br /> STAIE 9UIL�ING SIIRC,IIARQE � <br /> trveorr,oNsr vinNsnrvaovF�oInr CITYOFEVERETT run�icwonKs � <br /> .�{- / �I� _ LOCAL SALES -- �'-��� <br /> ,JL— �/ �aTE TAX CODE IS 3105 TO7AL �� <br />