Laserfiche WebLink
APPLICATIVA FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />fl DEMOLITION fl COMBINATWN rl BUILDING fl MECHANICAL tl PLUMBING f l SIGN <br />PROJECT AODRESS /�Z I C/ 4`��GJ %�V ;/T��� —� <br />ONTIER MAILADORE55 CITY ZIP P110NE <br />P�VIb(i�l.E C�E/-�RA2. gl(o pALIF�.L %✓E►�,E''�T �1�OZo1 Z�'iS -"712.3 <br />IENANT MRILAO��f.55 CIIV ZIP {'HONE <br />�f'�i�i <br />RRCHITF.CT OR �ESIGNER M�II. AODRE55 CITY ZIP PNONE <br />8✓l!G�i_u ►.�� i �,I�na, �2�G 44oYr An� �vt=,R.�—rt wor a6zo� z5�1-oS68 <br />nrv zir <br />MML RDDRESS CIN Z�P PIIONf. STATE UCENSE • <br />PWMBINGCONTRPCTOR MAILAODRE55 CIN ZIP PHONE STATELICENSE� <br />LEG�L DESGRIPTION OF PqOPERTY (SHOWN 9ELOW OR �TTnGH <br />LOT BLOCK OF <br />PARCEL TAI( LD. NUMBER <br />CONSTRUCTONLO�HLENUER.�OURESS.TELEPMONENUMBER <br />PLUMBIN6 <br />NO. TYPE OF FlI(TURF. OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHEFi <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK ISERVICE - BAR. ETC.) <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ � <br />FOR OFFICE USE ONLY: <br />fRONTSETPACK REAfiSETBACN SIDE SETB�FN <br />� � �Go ' � <br />USE ZONE� � LOT RREA VACRNL SITE <br />�1'4E5 f 1 NO <br />NEIGIIT LIMIUTION� NO Of OWELL�G' S2E OF BLDG�.I <br />S UNIIS � � <br />CCCIIPANCV NO 0�510niC5 OCCUPANTLOAD BASEMENT <br />GROUP � <br />!a f1vE5 11[NO <br />fIRE�LARM�RqEO[1 i1FA50Y <br />/w <br />� <br />onte <br />HEATING SYSTEM: f 1 GAS fl ELECTRIC f l <br />CONTRCT PERSON AND PHONE NO _ <br />JE�E�I� M.ouw- - G'�"J-v7.7fOa <br />P✓OT��Gtt , Nec��N `_ N�'c�,t- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHEF SPECIFIED HEiEIN 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 />PEFiFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPL�CATION IS 1 DE AND I COMPLY WITH THE STATE <br />CONTRACTORS 27 RCW AND 296200 WAC. <br />x � ' 2' S <br />SIGNQUR DRTC <br />CITY B1151NE55 LICENSB NO <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />rva.—rvnnuw urvna—n.r. <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATEP <br />WOOD STOVE <br />METAL FlFEPIACEI <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE $ <br />rinNc`-�n71%C� IFeer3�S�% �J I�ece�r�%iD�� <br />OUILIIMG <br />CLUMBING <br />MEC114NICAL <br />AU01I IONN. PI.AN GHlGN <br />O1HEA <br />STATE OUII�MG SIIIiG1nRGE <br />CITY OF EVERETT ���m�r,wonKs <br />LOCALSALES <br />TAX CODE IS 3105 TOTA� <br />