Laserfiche WebLink
APPLICATION FOR CONSTRUCTrON PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> 3200 CEDP,R STREET• EVERETT, WA 98201 •269-8810 <br /> f-1 DEMOLITION j�COMBINATION f(1 BUILDING �7 MECHANICAL �l PWMBING I1 SIGN <br /> PROJECT ADDRESS '7�2 � v Pn� ��a,F 1POvQ� ��/T <br /> OWNEA MRIIA�ORE55 ��Ty Z�P p110N[ <br /> 120� lGaoc�c��e- �5`' ��000 O,t? � 2 uiC-��7'r'� c.�r� 9 ��03 - <br /> if.NANT MAIL�DDRF.55 GiY IIC P��ONE <br /> ARCIIIiCCTORDE5IGNEP MPII R�pRE55 CItY ]iP PMONF <br /> G[N[lIAlCON1R4CiOR MAiLPDUR[55 CIIV LiP PnON[ StA1LUCFNSE� <br /> -DW N�. <br /> MECINNICALCONiRRCiOR MAILAD�RF. 5 (;�ry )�p p110NE STATELICCNSE� <br /> Pl11MBR1GCONtRACTOR MARAppRL55 Cltt 71P PHONE STAi[UCENSE• <br /> CONTR�CT PRiCE OP WORK � �� <br /> HEATINGSYSTEM: y'FaAS fIELECiRIC t1 <br /> DESCRIBE WOAN pND SOURRE FOOIRGE INVOLVE� CONTRCi PFRSON pN0�MONF.NO <br /> N oCc�C12 �-1 L(cG,—lo72Z <br /> 4WGC�— �SS—f�7`J w�s�, <br /> I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSEOFBUIIDING APPUCATION AND KNOW THE SAME TO BE TRUE AND CURRECT ALL <br /> S f�'� PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TYPE OF � <br /> r WORK WILL �E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPBOPERtt�SNONTIBELOWORRTfACNiWOCOPIES� NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> ior etocK or_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRU�':TION.THAT I AM AUTHOR2ED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIUN �S A1ADE AND I COMPLV WITH THE STATE <br /> o�qcE�inz i.o.ruuMaen CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTION IO�N LENpER,�pDf1E55.1FlEPNONE NUMBER x ��Q � / , � $/Z"/Q,j <br /> SIGNA IIR�E•j—S AiE <br /> QTY AUSINf:55110EN5C N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. iVPE OF EOUIPMENT FEE <br /> � WATERCLOSET(TOILET) � A/C—A/HNDLGUNITS—H.P. <br /> BATHTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LA'/ATORY(WASH 3ASit!1 i HEAT PUMP �— <br /> SHOWER � UNITHEATERS—B.T.U. M ; <br /> � KITCNEN SINK 8 DISP � CLOTHES DRVERS <br /> ✓ DISHWASHER VENTILATION FAN <br /> LAUNDRY TRAY � RANGE HOOD � <br /> CLOTHES WA;,HEFi � WATER HEATER <br /> URINAL � WOOD STOVE �_ <br /> ORINKING FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIPEPLACE INSf:RT(WOOD OURNING) <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SEqVICE—BAR,ETC.) GAS RANGE � <br /> � GAS PIPING <br /> � EXHAUSTFAN <br /> � � <br /> i � <br /> SUBTOTAL S � SUOTOTAL 5 � <br /> PERMIT S i PERMIT S � <br /> TOTALFEE S TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> fqONTSFTPACK RE4RVF.TBACN SIDESEIDACK Pt�NC11Ef.KNU !f-fi tGF �1[C[IPTNO <br /> `�/'� <br /> usG2orue iot�nr.0 VACANi51iF FEES VALUATION FEE <br /> fiYEp I1 NO � � <br /> _ ounmrs. C �� ;1�, <br /> H[IGRf LIAUiRiION NO OF OWElL14G 54F O�filDORI <br /> IINIIS <br /> PI UMpING <br /> � <br /> OCCUPRNCV NO�{SIOPi[5 OCCUP4N1 LOaO BI.SEMENT �,i��qqNIGL � <br /> GROUP <br /> IIVFS II NO — — — <br /> FIRERLAPAIPEOD (1fR5pN A�DIIION�IPIANCIIFCN <br /> OtI�CR <br /> fIRF.51'ti1NKlERPEO'D 1iFAcpN — -- <br /> S1AiC FIIIiIDING SUfiL11ApGE i <br /> FrrFovr,onsr rinNsnr�Euor � CITYOFEVERETT runncwo�Ks _. _ _ _ <br /> LOCALSALES <br /> ����t ����� TAX CODE IS 3105 1�O7AL _ <br />