Laserfiche WebLink
APPLICATIOrI FOR CONSTRUCT�JN PERMIT���� <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259-8810 <br /> rl DEMOLITION fl COMBINATION 8 LDING �l MECHANICAL i 1 PLUMBING f � SI3N <br /> PROJECTADDRESS U,�/�� _ U���, <br /> cin em r��ont <br /> OWMER Mall ADDRE55 /�� ^� a/�Q <br /> M I C �6� U1�Il� O �VF I`VC�2Ll7 Zi�J�2o?i r10NE� �/ —i <br /> IENRNT <br /> IAAII AOD11F.55 ��TY <br /> pqLHRCGIORDE5IGNER MAll/.�0�E5L <br /> Cltt lIP �MONF <br /> G[N[RRICCMMCiOii MAILPpDBE55 <br /> f,I1V 21P P�IONE $tPiClIC8N5E• <br /> ��n, ��p PIIONE SiATE IICENSE i <br /> MECIIPNICPLCONiB4CTOR MAILA��RE55 <br /> ��n, Z�p PHONE S7AiF.�ICENSE• <br /> PlUM61NGCONiRPf,iOR MAILf.DUAE55 <br /> LONTRRGTPRICEOF WORK HEATING SYSTEM: I-� GAS f I ELECTRIC f l <br /> , fN C tpCT CERSON PND PI�E NO ��� `�� � <br /> �ESCRIBE WORK�ND SOUARE FOOIAGE INVOlVEO � _ 1 6 <br /> L�� \� �Z � �NWFIRO <br /> e�•.o��. E "N aaoR <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 /> PROPOSED VSE OFBUILrv+c � � /� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � I�`� :�'��� p2p/�LL� N WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> .h <br /> LEGAl0EG5C1RIPTIONOFPROPERTY�SHOWNBELOWO�IPTt MI\VOCOPIES) AOUTHORITY TOTVIOLATEAOR CANCELETHE PROVSION OF AINY <br /> ��7�—B�p�K or C � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CON TRUCTION.THAT I AM AUTHOFlIZED BY TF1E <br /> CY.._ �- OWNER OF THIS P OP TY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAD AND I COMPLY WITH THE STATE <br /> � CW ND 296200 WAC. <br /> pVCEZL2%ID.NUMB� lA I 1J��1 / S / <br /> 6 �J��J <br /> CONSTPUCTON LO/N LENOER.RD�RESS,TELEPHO��E NlIMOER S�GNPiUP �Atr <br /> CIiY BUSiNL55lICENSC NO <br /> PLUMBING MECHANICAL ' FEE __ <br /> FEE NO. 7YPE OF E�UIPMEN� <br /> NO. TYPE OF flXTURE OR ITEM �— -- � <br /> WATERCLOSET(TOILET) � W'C—MiNDLGUNITS—H.P. _+-- <br /> � FORCEDAIRSVSTEMS—B.T.U. M E.A. �� <br /> BATHTUB � HEAT PUMP � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHESDRYERS — <br /> KITCHEN SINK 8 DISP ' � <br /> DISHWASHER � VENTILATION FAN � <br /> RANGE HO00 ' <br /> LAUNDRY TRAY WAiER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URIIJAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN ' <br /> F100R DRAIN � FIREPLACE INSERT(WOOD BURNING) <br /> � GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS GAS RANGE � — <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING ' <br /> � EXHAUST FAN � <br /> i <br /> i <br /> i <br /> � i <br /> SUBTOTAL S SUBTOTAL 5 i <br /> ' PEHMIT 5 �„__ <br /> PERMIT S ' TOTAL FEE S <br /> TOTALFEE S ' <br /> FOR OFFICE USE ONLY: necerrNo <br /> rinr+c��er +j nrn �EF <br /> fRONTSFTPnfN RF�R$FtOALN SIDESETpACN �S <br /> � FEE <br /> FEES VALUATION <br /> ❑SE 20NE lOT�RFA VPC4Nf Slif. � <br /> 11VE5 i'. NO �II��pING �20 � <br /> IIEIGIIT LiM1TATION NO Oi UWELLING SIZE O�I���R� �_ <br /> UNIi$ Pl11MI11N(i <br /> i <br /> BASEA�EN — <br /> OCGUPANGY NO C�SIOaiCS OCLIIP/.Nl IOAU J- ti'«������A� __ � <br /> cnour A y!ES �� NO i <br /> aooniroai.vi.nN c��rr.K __--i— <br /> i'IRERL4(iMREOD PFASON <br /> ^ O1NER 1 <br /> ✓ �( �� <br /> FIRF.$PRINAfRREO�D �fAcON <iA1CflUtlUi�:G<_Ilfif.114RG[ �\�� <br /> ivvcorr,or� rinN.cAr�nve�ov CITYOFEVERETT runiicwonK< _ ____�— <br /> �- LOCAL SALES TOTAL I <br /> �_ � nmE S <br /> TAX CODE IS 3105 .— —'-- <br />