Laserfiche WebLink
APPLICATA FOR CONSTRUC*DN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />1200 CEDAR STREET •EVERETT. WA 98201•257-8810 <br />❑ DEMOLITION ❑ COMBINATION !.BUILDING ❑ MECHANICAL ❑ PLUMBING SIGN <br />PROJECT ADDRESS' <br />/7Z9 Wes{- MAr,-je, VO Ar,ve- ��eretfi /i 98zo/ <br />ONNER MAKADOKsS c1t, zP mrlrt 4L5-31y a id <br />EL1e-r e-tt /I An AA 1/, L�Ly- Ph -11&r C o L�o,E Re rG £s- n (r-I Po B� 17oy EJare.ft; LJk98� <br />TENT - MAIL•DQrESS rY ZIP P oN[ <br />M4T)?FCr';d"s •f EVer,-it , /7zE Wesf-Mrrr,,& v,3 ar,Vc , Eva.re'* 1.7A- 95.10-1 3 a33 <br />PHONE <br />STAt LCCNSE <br />ALL, SO-J Go NS(T'E,c'/!•-I . PA Oi x /ZOLB,F_Ue a. was ani..&5317 -T23 cjco 4(C4- <br />PWMBING CONTR 10fl LMKADOIESS CITY ZP PNENE STAM LCENSE0 <br />CONTRACT PRSE OF NORM <br />2 2, 000 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑__ <br />DEscFmE wORFu sw141EF A.OE INVOLVED L <br />✓ a cCS i UCC 110-! <br />CONTACT PERSON MID hroNE NO <br />PA/f C011 A-o E- / r- 54fION,f <br />Ory nI GL` L ro <br />Pla•osco aF euuwuD <br />I HEREBY CERTIFY THAT I HAV READ AND EXAMINED THIS <br />APPLICATION 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 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 THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAD. <br />X _&-0 / <br />LEG&M PTgNCFPROPERTY(SN BELMMATLCNTYOCOPIESI <br />Lor BLOCK of <br />PABCELTM ID BUMDER <br />CONSIFIUCTNDN Low LENOFR. AppflESS TELEPHONE NUMBFR <br />TURF C J D+tE <br />GIY BUSINESS LICENA NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOILET) <br />AIC — A'HNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />I <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK d DISP <br />CLOTHES DRYERS <br />i <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />! <br />WATER HEATER <br />J <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE BURNING) <br />I <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />j <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKPLOW PREVENTERS <br />GAS RANGE <br />! <br />SINK (SERVICE —BAR. ETC.) <br />! <br />GAS PIPING <br />EXHAUSTFAN <br />! <br />i <br />i <br />i <br />SUBTOTAL S <br />SUBTOTAL S <br />PERMIT S <br />PERMIT S <br />j <br />TOTAL FEE S <br />TOTAL FEE S <br />! <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REARSETOACK <br />510E SETBAUt <br />PWNCNECKMMBER <br />/O7 - 0o <br />FEE <br />RECEIPT NO <br />um zw <br />LOTABEA <br />vAcuIT SITE <br />FEES <br />VALUATION <br />FEE <br />euEwrva <br />co <br />NEgHTmTATION <br />NO OF U'40 <br />uwrs <br />511E OF BL <br />KUMBMO <br />OCCM+NLY NOOFSMK5 <br />I <br />CCCUPANF LO+D <br />3 <br />eASEMEW <br />v <br />FIYES �JNO <br />MECNAF4C4 <br />ADOITPNAL KAN CNECK <br />FPESIMIINK RPEOU <br />cJ <br />MASON <br />/ �j1� <br />--K;ms "w" <br />OrNER <br />MEµMM KO <br />`/� <br />REASON1N1 �./� <br />�^IJ// <br />STATE" NO suR "- E <br />UK OF fANST <br />i <br />f—HpLOCAL <br />KANs .ce eY <br />7 <br />D.t Fj <br />CITY EVNT <br />L <br />TAX OE S D9 05 <br />KreLE NGRKs <br />TOTAL <br />