Laserfiche WebLink
APPLICATIf`�V FOR CONSTRUCi""DN P�EEiMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION p COMBINATIO�N ,�BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: '�i �� � �� II <br />1 f�occz e Hr <br />��lo� G�L �CU(I ii �.i <br />��Ep � M,I�IL�ODHESS <br />t-iC�S ('�i`��'1j:�1 �" �� <br />TEN/JI 4NL E55 / <br />_�, '�lnt�� �SZJ-1 i��� ` <br />�c <br />ARGN�TECT O{i pE GNER r All ADORE55 <br />�CG� ��TiC� '�O(.Jr�P� <br />GENERACONiR�GTOii MAILA�ORE55 <br />rwmomuUlrylNn�TOq M�ILADDRE55 <br />� <br />CONfR/�CTPqICE K <br />��.,Q. COCJ <br />DESCPoB[ VNMK AND SqJ�RE FqOTAGE I�{VOLVED <br />Nc'}J �oo� S'iw-c�re <br />��;n� sko(� <br />PROP'OSEO USE OF BUILpNO <br />LEG�l0E5CRIPTION OF PpppEflTY ($NOWN BEIOW OR ARACN <br />LOT BLOCN OF <br />PAqGEL T� 1 qD. NUTABER <br />�V 6v� Q� <br />CONSTRl1CTIpN LOMI LENOER, ADDHE55, TELEPIIONE MMAPER <br />PLUMBIN6 <br />� NO. TYPE OF FIKfURE OR <br />1 WATEP CLOSET (TOILEn <br />' BATHTUB <br />� LAVATOHY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTFAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN ! <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />fRONTSETP�GK REM SFTBACN <br />USE20Nf: tOl�qE� <br />11EIG11TLIMITATION NOOFDWELLING <br />UNIi[ <br />N <br />NR <br />rrreorcoNst rinNs�vno� <br />V- � �„E �`� <br />FEE <br />Jc' )'C� <br />r��oNe <br />�rlwiov����v� /��7�' ?s % > > S5 <br />CIIY 7iP PIIONF <br />3>'9 �3� Zs�'7 /�s/ <br />���r 7�� ���ONF SteTEll [NSEi <br />CIIV 71{' PIIONE STATE IICENSE / <br />CIfY zlP PIIONE STATE LICENSE � <br />0 <br />IIEATING SYSTEM: ❑ GAS O EIECTRIC ❑ <br />LONIACTPEpSONANDPHONENO <br />L /.`rr. i Q�lI _t_'; <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED 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 NEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV <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 FOH WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STAI'E <br />CONTRACTORSJ'�W 1827 R W AND 296.200 WAC. <br />f <br />x ��` f -/5-%� <br />SIGN�IIME ' � D�l[ <br />CIIY BUSINESS IICENSE NO <br />MECHANICAL <br />NO. 7YPE OP EpUIPMENT FEE <br />A/C—MINDLGUNfTS �— <br />FORCED AIR SYSTEMS � <br />� <br />HEAT PUMP , <br />UNIT HEATERS ... � <br />WATER HEATER <br />WOODSI"OVE <br />METAL FIREPLACE <br />FIREPLACEINSERI <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL 3 <br />PERMIT S <br />TOTALFEE E <br />$IDESf70�f.N p1�NCUCCNNUMBf11, ff( ��, �fCfIPiNO <br />-- .�,3��� _ 5��� _ <br />veceN� snr FEES VAWATION <br />❑YES Il NO /�O <br />OUII f11HG � <br />SIIE Oi BIUGR I ----- — — <br />� �� PIIIMpINI: <br />BASEMENI MECIInNIC�I. —'-- ---'------'— <br />❑YES ❑ NO - -- - <br />— �DD�IIONAI. PI AN CBI CN <br />�����„ --- ---- - <br />suie nunon+c sunc�unc.c <br />� CITY OF EVERETT runur, wonKs <br />LOCAL SALES -------- — --- — --- <br />. i, ) TAX CODE IS 9105 TOTAL <br />