Laserfiche WebLink
APPLICATII.+d FOR CONSTRUCI.ON F�ERIIAIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f-1 DEMOLITION f-1 COMBINATION (l BUILDING 5Q MECHANICAL i l PLUMBING fl SIGN <br />PROJECT ADDRES �/� v O�l V`�.' .-�. ��-"r� 1 1 , W a� ��� D� <br />� <br />OWNER MAILAD�RESS CIiV ZIP PNONE <br />��r<�nie �'ria�eo64�1� SF//O /"j�'E•Sy�. Fi�erc.tf'. �,,tsi, 9�a03 3C3 - O�[>�' <br />iENAN MAILApDRE55 C17V —� ZIP FIIONE . <br />ARCHITECTONUESIGNER MAILAOORE55 QiV 21P PHONE <br />GE/NE�iiRLCONTAl1CTOR MnI1.�DURE55 CITY IIP PNONE $TQELICENSE� <br />�{/��'{i�Y'�n6�p �arf%E'»'��t.r�r 3515 Q4�r;SE. ruErclf 39702q7 �bPGHO.-53.D8 <br />MEC /�NIGILCONTPAC70R MRILA�DRE55 CITY ZIP PHONE STA`ELICEN$E� <br />PLUMBINGCONTRACTOR MAILADDRE55 CILY 21P PHONE SiATEUCENSE� <br />�or <br />op <br />�— <br />FOOTAGE <br />OF PROPERTY �SHOWN BEIOW OR RTTACN <br />_ BLUCN OF <br />CONSTRUCTION tOMI LENDER, �DDRESS, TELEPMONE NUMBER <br />PLUMBINO <br />NO. TYPE <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />LAUNORYTRAV <br />CLOTHES WASHER <br />OR ITEM <br />SUB <br />FOR OFFICE USE ONLY: <br />FRONTSEtAALK REARSETORCK <br />USE[ONE LOiRREA <br />HEIGNTLIMITRTION NQOFUWELUNG <br />UNITS <br />OCCUPANCV Np OF Si0R:E5 OCCUPqNT IORD <br />FlRE SPRINKLER REO'D I REASON <br />ORTE <br />FEE <br />5 <br />HEATING SYSTEM: P4 GAS ❑ ELECTRIC fl <br />CONTACTPERSQMpNOPNONENO. �, / <br />t HEREBY CERT�FY THAT I HAVE READ ANU EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVIS�ONS 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 PP:SVME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVI:ION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONS7RUCTION. THAT 1 AM AL'THORIZED BY THE <br />OWNER OF THIS PROPEfiTY TO PERFORM THE WORK FOR WHICH <br />APPLI(;ATION IS MADE AND I COMPLY WITH THE STFTE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />X. l MA�tt �f' :'/'n'7(�j�� J-%� p�J <br />SIGNATU��I DATE <br />31LnD3 <br />CITY BUSINESS LICENSE N0. <br />�AECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C - MiNDLG UNITS - H.P. � <br />FORCED AIR SYSTEMS - B.T.U. M E.A. ; <br />HEAT PUMP � <br />UNIT HEATERS - B.T.U. M ' <br />CLOTHES DRVERS � <br />VENTILATION FAN � <br />RANGEHOOD ; <br />WATER HEATER � <br />WOODSTOVE ' <br />METAL FIREPLACE (WOOD BURNING) i <br />FIREPLACE INSERT (WOOD BURNINGI ! <br />GAS <br />GA.i <br />SIDE SETB4CK PLAN LHEC� ER� <br />l <br />V4CRNT SITE FEES <br />fIYES fl NO BUILOING <br />SIZE OF BIDGRI. <br />PLUM�ING <br />dASEMENT MECMRNICAL <br />IIYES fl NO <br />ApDIPONRL PLPN CNECK <br />OTHER <br />STRTE B19L01NG SUIiCHRRGE <br />CITY OF EVERETT rueuc wonres <br />LOCAL SALES <br />TAX CODE IS 3105 TUTAL <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />fEE I AECEIPTNO. <br />