Laserfiche WebLink
APPLICATIG.� FOR CONSTRUC7 .JN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> f7 DEMOLITION rl COMBINATION �� BUILDING rl MECHANICAL i l PLUMBING f� SIGN <br /> PROJECT ADDRESS p� / �AG� fI C /�UE. EUC�C� �ti�� , <br /> � <br /> OWNER MaILADOFESS CITY PP PMONF. <br /> teF� R A��os ,�,2.s N,�u. /63Re S'� .sE�7ile 9�si77 3�16 - y7 <br /> TERAM M4ILADDRE55 CIiV ZiP PHONE <br /> AR"f:rM�RE1-CT�O/PGESIGNEP MIJUDDRE55 I/ y�C'ltt/�� 71P PMOpN[p <br /> I\ (/U1� Y. ��qQWf\� ��� f�u.J! // /I'./l.� EUC'{/qti'�JY� l•V4i I0�0� <br /> GENERAICONTPRCIOR ' RDORE55 ,�c Cltt ZiP i PIICNF SiAiELICENSE� <br /> MAChiV+S' C'oNSfRML.f70N', 14.�1 ISy �R. I'U� E, SNOltOI�++Sti, �t/U �YX90 /�7ACN/[e[6/Fr <br /> MECH�NICALCONTRACTO� MAILADDAE55 diV ZIP PIONE STRtELICENSE• <br /> PLUFIBINGCONiR�CTM MAILADDRE55 GITY ZIP PHGNE STA�ELICENSE• <br /> COM1TA�CTPRICEOF K <br /> `�; � HEATING SYSTEM: f 1 GAS I-1 ELECTRIC Ll <br /> DE!iCRIBE WORK AN'J SOUARE FOOTAGE INVOLVED /� CONTACT P[RSON RND Pf10NE NO <br /> _ AQQIY-�n►V cX � - 2� TO(� Sf'Qf�( C(1.IRS tv .VCh'Iw . C. <br /> _ LR�uOi��� Re�+oac� Ek�sr�7v s?n� lk�LsE rr � -G�66 <br /> I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> PiOPOSED USE OF BUILDIN(3 APPLICATION AND KNOW THE SAME TO BE TRUE AYD CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> t7(IST/hl � QQUt�T��tL G�lW/G WORK WILL BE COMPLIED WITH WHETIIER SPECIFIED HEREIN OR <br /> L56�LDESCRIPTIpJ PROPERTY�SNOWNBEIOWOR�TfACN7WOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ur e�ocK IJ y oF t G C O!l� '� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> .,a c I1 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> ! n� C. SO � If LI'f' IFi'I9 �LJS �e �v. ,�f � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> e C" �� r{ (�r' APPLICATION IS MADE AND I COMPLY WITH THE 5TATE <br /> ��ARCF.L TAX I. .NUM�BER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTMICTION LO N LENOE�DORE55.T�HO�NOUMBER x /{��/'(i LL'rj-Q/ //iy/9� <br /> SIGNATURE �ATE <br /> 0�8 /68 <br /> CITY BUSMESS LICENS@ N0. <br /> PLU'M81N0 MECHANICAL <br /> N0. TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF flXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASM) HEATPUMP � <br /> SHOWER UNIT HEATERS—B.T.U. M � <br /> KITCHEN SINK 6 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAY ; RANGEHOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FlFEPLACE(WOOD BURNING) � <br /> —�— <br /> FLOOR DRAIN � FIREPLACE INSER7(WOOD BURNINu) � <br /> BACKFLOW PREVENTERS i GASFIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING �_ <br /> � E%HAUSTFAN � <br /> � � <br /> � �� <br /> --�- <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> i <br /> AERMIT $ i PERMIT $ i <br /> TOTALFEE $ ' TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: -��r��,� _�,,-; �� �; <br /> FROMS�K� REARSE�IS SIDESF.TB�C�—�O PLANCHECNN�OER� / FEE_ ^ �).� RECEIPT%,� � <br /> ^ // (J <br /> S / 7-� <br /> usezoy� ^ toTnnen vnenmsire � FEES VALUATION FEE <br /> _lG'� nves No euaoiNc �.DW ,� ...J� �� <br /> HEIGNT1.I►1IT 19N NOOFOWEIIJNG SIIEOfALIX9Rl. i <br /> L� UNITS � S1Q.F j• PLUM9ING � <br /> / <br /> OCC�PANCV NO OF Si0FIE5 OCCUPANi LOAD BASEMENT M[C114NICnL i <br /> ,'1 � flYES Il NO i <br /> ADDITIONPL PLAN CH[CN i <br /> FIREAURMFEO'D REASON i <br /> N�, OTNER � <br /> FIRE�'RINKLFRAEOD RF.ASON i <br /> N �1 STPTE PUII�ING SUfiCHAiiGE / i f f <br /> TVPEOFCONST. PLANSAPPROVEDBY CITYOFEVERETT r��m��won�.s ; <br /> r,� - I �A- LOCAI SALES <br /> ✓ � r o�Te a- I _ j TAX:ODE IS 3105 TOTJIL ' �r 1 <br />