Laserfiche WebLink
APPLICATI�..� FOfi CONSTRUC7 .�N PERMIT <br /> CITY OF EVERFTT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOUTION ❑ COMBINATION f� BUILDING Cl MECHANICAL Cl PLUMBING fl SIGN <br /> PROJECT ADDRESS � <br /> ZZO c. �OC, ' t= Y' �-���� ��i � �i Q� c�c� <br /> OWNER MaILqDORESS CITY 21P t'NONE <br /> N��y�\ HI r u a.;�� �;'��,� � ,- c:�c� �, /l�; ��! _�', ��,< . � ��``"` -�---�'?; <br /> fENANT �„ —T MAILAGDHF.55 CITY 21P PIIONE --r <br /> ��:�l�_ <br /> ARCHITCCTOAUESIGNE(i MFILADORE55 CIIY ZIF PHONE <br /> '�_`-� � o rl <br /> GENERRLCONRipCTd7 MAILAD�RE55 CITV ZIP_, PNOYE STATELICENSE� <br /> ��lA� l-����ZL-"�� ��.�lSIZ=;� �?Z�1�'1 ��-l�'�,ed�; �`��c c- �ti'1 �I�('1�i 1v4 2T!-4i �I �-� IT,��iF'7 <br /> MECHPNICALCONTRACTOR MAILAD�AESS Citt ZIP PIONE STATEUCENSE� <br /> �1i'Nt/\ L� <br /> PWMBINGCSNTRACTOR MAILADDRESS CITV ZIP PHONE STATEUCENSE� <br /> coNrRncrvaiceoFwoaK . . HEATING SYSTEM: Ji GAS ❑ELECTRIC C.' <br /> � � � � - <br /> DESCRIBEWORNANOSOURRE SbT�GEINVOLVED CONT�CTPERSONANOPHOYENO. <br /> �.��Il-i�s_�' <br /> ��,;y.��_ ��.?1k--� �`�`�d��F� . .. Z �_-� ( -� <br /> rr....�r.. . <br /> � _ C � ,� � �.�� � , I HEREBY CERTIFY THAT I HAVE READ 4ND EXAMINE� THIS <br /> APPLICATION AND KNOW THE SAME TO 8E TRUE.4ND CORRECT.ALL <br /> PROPO4'cU USE OF BUILOING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERE�N OR <br /> �EGALDESCRIPTIONOFPROPERTV�SHOWNBELOWIXi4TfACNTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior s�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PPOVISION 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 PERTY PERFORM THE WORK FOR WHICH <br /> APPLICATION td N I COMPLY WITH THE STATE <br /> PAPCELTAX ID.NUMBER , CONTRACT S LA B^ W AND 296200�C.� <br /> • � � •• • � <br /> � � <br /> f;N57AlICT10N ORN ENDER.PDDRE55.TELEPIIONE NUMOEP x <br /> SIGNniURE D E <br /> � �--�–�� _ - . . ... ._ . . .. . . � CIiVBU5ME55LICENSENO. <br /> - PLUMBING MECN.^.l7;CAL <br /> ��- ' � " � � � NO.� �� IYpE QF FIXTURE_O_fi ITEM. .__ _ .�,_�tE _ , _ , NO. TYPE OF FI%TURE OR ITEM FEe <br /> WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. �— <br /> BATHTUB ; FOACED AIR SYSTEMS—B.�.:U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP �— <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK S DISP ; CLOTHES DRYERS i <br /> T <br /> DISHWASHER � VEN-i ILATION FAN � <br /> LAUNORY TRAV fiANGE HOOD � <br /> CLOTHES WASHER i WATER HEATER �— <br /> -�-- <br /> URINAL ' WOOD STOVE ; <br /> DRINKING FOUNTAIN � M.ETAI FIREPIACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVE��TERS � GAS FIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> GAS PIPING <br /> � EXHAUSTFAN � <br /> � � <br /> � � <br /> � � <br /> � � <br /> SU�TOTAL S ; SUBTOTAL S ; <br /> PERMIT 5 i PERMIT S � <br /> TOTALFEE 5 � TOTALFEE ffi � � <br /> FOR OFFICE USE ONLY: <br /> °RONiSETAALN RGr^SETDACK $IOESETBACK PLANCNECKNUMOER �EE RECEIPTNO. <br /> - r <br /> � , /�--' :/' <br /> >EZONE tornaen vncnnrsire FEES VALUATION FEE <br /> flY[5 fl NO pUILDINO � <br /> IGMi LIMI7F710N NO OF OwELLING S12E OP BLOGR.L � <br /> UNIiS P�UMOING i <br /> �OPAYCY NOOFSi0F1[5 OGGIIPANTIOA[l BASEMENT M[CHANICAL � <br /> nves n r+o , <br /> 4URMREO'D REASON PODIPONALPLANCHECK i <br /> i <br /> OT11ER � <br /> i <br /> SVBINNLERFEQ_ FEFSON i <br /> STATE BUI�DING SURCMARG[ i <br /> i <br /> �rcoNsr v�nNsnrrnoveoev CITYOFEVERETT PUALICWORKS � <br /> LOCAL SALES � <br /> DATE TAX CODE IS 3105 TOTAL I <br />