Laserfiche WebLink
� � <br />APPLICATION FOR COIdSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERE'TT, WA 98201 • 259-8810 <br />O DEMOUTION Q9�COMBINATION �BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: � /o�U� S�IflQ ('.,,��ll <br />�ncNrtccr <br />cd�� ���� �� '�9oy <br />PLUMBING CONTR� TON �r� RE55 Cltt Z�P PNONE STATE LICENSE � <br />C•7 <br />PROPOSED USE Of <br />LEWL DESCRIPTION OF PROI'I <br />l0T �_ BLOCK <br />�'v. �`S .Sv� <br />INVOIVEU <br />�ii.y�^ vvT <br />.OAN LENOER, �OOi1ES5. <br />NO. TYPE OI <br />WATER CLOSET <br />BATHTUB <br />? LAVATORY(WAS <br />KITCHEN SINK 6 DISP <br />DISHWASHER � <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />Bh. ,r�OW PREVI <br />SINK (SERVICE — <br />OR ITEM <br />SUB TOTAL S <br />PERMIT S <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK AEAR SETB�CK <br />VSEZONE 7 IOTAPE� <br />� ` <br />HEICNTUMIT�TIOH NO.OFDWELLING <br />,�Q � UNIiS <br />� <br />RE�'D <br />�N <br />�-i <br />FEE <br />SIDE SETBACN � <br />�� <br />VACANT SITE <br />❑YES ❑ NO <br />NEATIYJG SYSTEM: �GAS ❑ ELECTRIC ❑ <br />CONT�CT^f.R50NANUPHONENO � <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF <br />WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TMiE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />x /r�i ,. .Af'r�� �-t'�'c�l �% <br />SIGNATU�E � DATE <br />CITY BUSiNE55 UCENSE NO. <br />NO. I TVPE OF EQUIPMENT I FEE <br />rv�.—rvnnuw �i���o � <br />FORCED AIR SYSTEMS ; <br />HEAT PUMP � <br />UNIT HEATEFS ' <br />CLOTHES DqYERS � <br />FLINGE HOOD ! <br />FIREPLACE� <br />ACEINSERT <br />GAS <br />SUB TOTAL f ' <br />PERMIT S � <br />TOTALFEE S ; <br />PUN CIICCK NUMFI[Il i FEE �� � I �Ef.EIPT NO <br />OUILU�Nf: <br />SIZE OF BLD6?.I — <br />1031 S,F, vwumuc <br />B� NENT IAECNeNIL�I <br />❑ rE5 I�NO <br />RDD1110N�I. PLAN CIIf.LK <br />Oil1En <br />ST�IE OUIIDINC SUnC11nnC.E <br />CITY OF EVERETT rueiir.wonK� <br />LOCAL SAIES <br />TAX CODE IS 3105 TO7AL <br />