Laserfiche WebLink
CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> f7 DEIWOLITION fl COMBINATION ji BUILDING I� MECHANICAL t� PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> O'� 1 - u= � C—V <br /> OMMEq /MILADDRE55 Cltt 21P PHONE <br /> ��—.� r�.r -,r,g,,�D �� �M�, f ���r,r-.p ���o i�A�E.r�� w ��N�,.a.j 9�,z� 77S n�4� <br /> TE;N�MIT MAIL�i Rl1[' E55 Cltt 21P {`IIONE T� <br /> �APP� �=���1 5fi{/-��vn4lTv,y�� � ��ZO( Z_�i�—�R7� <br /> ARLPoT[CTORDESIGNER M�IL�ORE55 GITV ZIP PNONF <br /> �!�_{��I�i NEtuENNLJ77G K <br /> fiENEq11�CONTMLTOR MqL11DDRE55 CITY liP PIIONE STATELICBNSE• <br /> �xz.,3�d�rr- Sw� ILr� St SCJ L�,,,,,, ,�d, t�ca 'lq� -3�3,p <br /> ME ANIL�L CONTPIIC OR M IUDDRESS Cltt IIP ,FTIpNE STRTE LICEN$E• <br /> a�w �- qdzs q���^St. ,cr Aou�,T,,�l,�w�g 659 -1Jn7 �vP+�w iv�T�--- <br /> PLUA101NG CONTP�CT M�IL�E55 CIIY ZIP P NE STATE UCENSE� <br /> CONTiUCTPPoCEOF WORK /" ,����y HEATING SYSTEM: q GAS fl ELECTRIC f� <br /> �p✓t-�l.V- <br /> DESCE118E WORK�ND$OU�RE FOUTA6E W VOLVE� CONTACT PERSON AND PNONE NO. <br /> I � .�. CLING <br /> • � � /� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> rnoroseo use oc em�drxa APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN C!'i <br /> �ea�ioesc PTIplOFP{IOPERTY�SIqWNBEIOWOR�RA(NTWOC �PIES� NOT. THE GRANTMG OF A PERMIT DOES NOT PRESVME TO GIVE <br /> �or e�ocu oF � AUTHORITY TO V�OLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW RE6ULATINO CONSTRUCTION OR THE <br /> scc 4�r � e L E4 PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTY TO P O THE WORK FOR WHICH <br /> APPLICATION IS MADE AND PlY WITH THE STATE <br /> PAACEITiUf I.D.MIMBER CONTRACTORS LA 827 N 200 WAC. <br /> LY�„��../nc�A Mr - G' 353- � � <br /> CONSTRIICTION LONJ LfNDEH./�d1RE5S.TELEPHONE MIMBER X v ` �— <br /> SI R DA7E <br /> � b���� Q SLICENS[NO. <br /> PLUMBINO MECHANICAL <br /> NO. TVPE OF FlXTURE OH REM FEE NO. 7YPE OF EWIPMENT FEE <br /> . ; �� NiATERCLOSET�TOILET) � - A/C-PJF{NDLGUNR'S-H.P. ' <br /> BATHTUB ; FORCED AiR SYSTEMS-B.T.U. M E.A. ; <br /> y LAVATORV(WASH BASIN) � HEAT PUMP � i <br /> . -. � FiHOWER ' - UNIT HEATERS-B.T.U. M ' <br /> KiTCHEN SINK d DISP i CLOTHES DRVERS i <br /> DISh'WASHER � VENTILATION FAN � <br /> �, '�• UUNDFiY TRAV ; RANGE HOOD � <br /> CLOTHES YY�SHER i WATER HEATER � <br /> � URINAL ' ` WOOD STOVE ' <br /> -- DRINKIN6 FOUNTAIN i � METAL FIREPLACE(WOOD BURNING) i <br /> -- FLOOR DRAIN � " FIREPLACE INSERT(WOO�BURNING) � <br /> — BACKFLOW PREVENTERS ; l GAS FIREPLACE ; <br /> �— SINK(SERVICE-BAR,ETC.) � - GAS RANGE � <br /> ' GAS PIPING <br /> i EXHAUSTFAN � <br /> � � <br /> SUB TOTAL E ; SUB TOTAL S ; <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLV: <br /> FRONTSEIp�C RE�RSF.TB�CN� S��ESETPnLN i PUNQIECNjNUbIflf.R FEE l � RECEIPTNO. <br /> � � � d �� �L/��'. � J� <br /> usezor� /J LOIAREA vecnHrsrte FEES VALUATION FEE <br /> � -�� .rlrEs f 7 NO sunnn+a � Z�0 2 �� <br /> NEIQNT UMITATIpN„ � NO OF OWF.LLING SITE Of BLIXirtI i <br /> //lC ur+�rs F Civ��l.. � <br /> vL � /�/ 7 �F riun+nir+c _ 3� <br /> 06CRCOUP�NCY Np pP510�ES OGCUPANTLO�D BnSEMENf I/�/ M[C11nNICAL � <br /> . V.� ��YES ��NO �i <br /> FIFE qARM REOD RGASON ADDIIION�I PI nN CHfCN � <br /> i <br /> OiHER � <br /> FIRFSPRINNLERRE00 RF.A$pry � <br /> i <br /> SIM^ffllllDMC SURCII/.fiGE � <br /> 71'PEOFf,ONST PIANSAPPP �veypev CITYOFEVERETT PUpI1CWORNS <br /> 7'� LOCAL SALES 2D � <br /> ���� o�te / `J 5' TAX CODE IS 3105 TOTAL 7 I Q <br /> r <br />