Laserfiche WebLink
� <br />APPLICATIO.. FOR CONSTRUCTI.�N PERMIT/ <br />CITY OF EVERETT • BUILDING DIVISION yC���� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 2'9•8810 � <br />❑ DEMOLITION ❑ COMBINATI04N ��`BUILDING �� MECHANICAL L� pLUMBING ❑ SIGN <br />PROJECTADDRESS: ��D,i(p 2 � y <br />i_ <br />OYMER <br />M�IL �Dp1E�5 <br />�1:Sti u�'�l <br />��n' ZiP PNON[ <br />._ _�. _�....t„� � cn. nv ruor�i, <br />, i <br />Ai1L111TEGTOqDE51GNER MNI I�DDfiESS �ITY )II` �IIONf <br />YF+r� KNCT�s� � � �t5^9 'i3 <br />GENERAICONIMGfO{i MAIIADDBE55 CIIY I�P P�IONE SI�IEIICENSE� <br />�'v4� .c �.a ..�T i-it�wsi .Ti�t 2� 5'+ 3� r4.�E �,1 f� � �..� 4 flo3 c 3S(.-1Ai � Fvt�rctr< <-I To'7131 <br />MECHANICALCONTP�CTOR MMLADpHE55 Lltt 21P PIIONE STATEIICENSEr <br />PIUMBINGCONTReCTOR MML�OORE55 CI1Y zlP PHpNE S7AIEUCENSE� <br />� <br />SOU�RE FOOT�(]E <br />LOT _ � �� BLOCN `-_ -%Z Of �/�'�1 /�� $ / $T <br />PAqCELTA%I.O.NUMBER <br />COINSTRlICT10N lOM! LENOEP.I10DqE55. TElEPF10NE tNMpEP <br />4�M� ( Un �L• � f_��w i rf-�2KM�F <br />P�(- "�� 5—S�2c. <br />PLUMBINO — <br />NO. TYPE OF FlX7LpE OR ITEM FEI <br />WATER CIOSET (TOILEn <br />,�Z BATHTUO <br />,3 UVATORY (WASH BASIN) <br />SHOWEq <br />KITCHEN SINK d DISP <br />/ DISHWASHER <br />UUNDRY TRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />PERMIT S <br />TOTAI FEE E <br />FOR OFfICE USE ONLY: <br />FRpNT SETp�CR PEAq $ETB�CR <br />�-�� / 7 S � /" <br />USE 20NE /^� tm enen/'y� <br />/�- Z �i'� <br />NEIGNi UMI7�TION NO OF DWEIUNG <br />,� �- VN11G ' <br />OCCUPANCV � 1q (H SIMtlFS OCCUPANT 10�D <br />REO'0 <br />FINE AIMM flE0'0 <br />1'� <br />SIDE SFTB�CR <br />V�C�NT SIIE <br />YES ❑ NO <br />❑YES [y1Pf) <br />CITY OF EVERETT <br />LOCALSALES <br />TAl( CODE IS 3105 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CONT�CT PEFSON AND PNONE 110 <br />_ IMhxT n� i31tU W1J 2l O— 5 i�9 <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 UWS AND ORDINANCES GOVERNING THIS TVPE 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 TU VIOLATE OR CANCEL THE PROVISION Of ANY <br />OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS F`ROPERri TO PERPORM THE WORK FOH WHICH <br />APPIICl�TION IS MADE � AND 1 COMPLV WITH THE STATE <br />CONTRp1CTORS lAW 1827 RCW 4ND 296200 WAC. <br />oin <br />NO. � TYPE OF <br />FOHCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />INSEPT <br />GAS RANGE <br />GAS PIPING <br />FXHAUSTFAN <br />�UN CIIECN NlIMO[f1 <br />ounon+r. <br />PlUlUOMG <br />MFCN�NiCAI <br />ADDIIION�L PL�N �Nf.CK <br />on�en <br />SIRtE Bl11lOWC SURCIUpGE <br />rup� Ir wonnG <br />TOTAL <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE S <br />t'E�O I f1ECEIPi NO <br />