Laserfiche WebLink
W1 <br />APPLICATIO.1 FOR CONSTRUC7'. JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />�DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANIC.AL ❑ PLUMBING ❑ SIGN <br />L� <br />PROJECTAQDRESS= �-�� Rockcklltr /�✓C �t(�t <br />IEN�Ni <br />�RCMTELT OR DESIGNER <br />}��v�kUm <br />r� ���r <br />M�ILAUDRE55 <br />M�IL 11I1DRE55 <br />M�II ADOnE55 / <br />�ar,.,L'�n �6Z% <br />f.I1Y 71P <br />l.i � 711` <br />�qor ,Qr� ; <br />VIIONE <br />w�4 9&z5� .335-/968 <br />j0� •zOZZ <br />ENSE• <br />MECNANICAICONTN�CTOR N�II�DIN�ESS CIiY 21P P110N[ SUTEII�F.NSE• <br />PIVI/BINGCONIR�CTOR MML�OO�ESS CIfY Z�P P110NE ST�fEIICENSE� <br />FOOTAOEINVOLVEO <br />PIqPOSED USE OF BUILpNf3 <br />TVA COPIE51 <br />�C�or I'Z"3 a�«K �_ or ls"' g <br />Vo�umt 3 Pave 74 <br />� �9So�os-oo�,0000 <br />CONSTRVCTION lUN1 lENOER. �OORESS. TELEPNONE NWBER <br />NO. TYPE OF flXTURE OR ITEM <br />WATER CIOSET (TOILEn <br />BATHTUB <br />LAYATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 3 DISP <br />DISHWASHER <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FqUNTA1N <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB i�OTAL S <br />PERMIT f <br />FOR OFFICE USE ONLY: <br />iRONTSETB�LK PEM SF.18�CK <br />USE ZONE <br />HEIGHT LIMITATION <br />OCCUPANCY Iq(%5 <br />f ROIN <br />FlRE SPRINKIER REO'D <br />IOT�RE� <br />NO OF OwELLiNG <br />UNiiS <br />PlANSAPPnOVEbflY <br />o�iE <br />9DE SETB�CM <br />HEATING SYSTEM: G GAS ❑ ELECTRIC ❑ <br />CONT�CT PEASON AND PHONE NO <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS TYPE OF <br />WORK WILL BE COMPLIED Y1'�TH WHETHER SPECIFIEO 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 />OTHEH STATE OR LOCAL LAW HEOULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPIICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW iB.27 flCW AND 296200 WAC. <br />SIG R� // � D�TE <br />�� <br />CITY BUSiNESSIiCENSE NO <br />� A/C—AMNDLGUNfTS <br />; FORCEDAIRSYSTEMS <br />� HEATPUMP <br />� UMTHEATEFS <br />� CLOTHES DRVERS <br />� RANGEHOOD <br />; WATER HFATER <br />� WOODSTOVE <br />� MEfAL FIREPLACE (WO( <br />; FIREPLACEINSERT(WO <br />� GAS FIREPLACE <br />; GAS RANGE <br />SUB TOTAL f <br />PERMIT S <br />TOTALFEE f <br />ri�N c�iccK r+u�.u+rn ,-, I �EF I nFCEmr uo <br />WC�Nf SIIE PeW <br />❑YES ❑ NO p������H� <br />SIZE OF OLOCR I <br />t'l IIMOIN6 <br />9�SEMENi AIFCIIANIC�L <br />❑YE$ ❑ NO <br />AD01I IONA� PI �N �Hf.CK <br />G�11Ef1 <br />ST�IE OWIUlYf.51111GN�t1�E <br />CITY OF EVERETT runnr, worixs <br />IOCAI SALES <br />TAX CODE IS 3105 TOTAL <br />FEE <br />