Laserfiche WebLink
APPLICATIO.J FOR CONSTRUCT.JRI PEFEMIT <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> f 1 DEMOLITION f 1 COMBINATION i� BUILDING I l MECHANICAL i 1 pLUMBING f 1 SIGN <br /> PROJECT ADDRErSS <br /> �1 1 VicrO�' f�ALE <br /> OWKER � MAILAODPESS CItV ]�P PItONE <br /> �NC�s N6N%an1 3ri7 v�crz�r Pc�c-:' �dt�r-�rr �✓A �8zo/ Cc�) zs•)-4zzz <br /> 'ENRtli 1AAILADDPfSS f.ItY 2�P PIIONE <br /> NA <br /> ARQIITEGiORD[SIGNER 1dAlI.NODR[55 CIiV ZIP PHONE �k'� <br /> T,�,�( ����Y "f�s� �f'rMtiC�/1�>>��� IGs�� Nw; qq �yNNw�o� ,bc�� �43�s5; a•�PFo`ir�r <br /> G[NERALCONiPPC1pR MAIL�DDRE55 CI1V 21P PIIONG STATELICENSE� <br /> � n <br /> M�Cl/ANICAICONTPACTOR !AAILADDRF55 Cltt ZIP PIIONG STRTEUGENSE� <br /> �'. n . <br /> PLUM1!BINGCONiRACTOR MAILRDDRE55 dtY ZIP PHONF 5T4iEUCENSE� <br /> N-r• <br /> coNtPncr PniC'oP wonR <br /> � H 37�j EA7'IaG_SYS�M:/i GAS �l LECTRI6,�t�, <br /> OBSCPI�EWORNANDSOUAREFOOTRGEINVOLVED CON�ACiPER50NAN�PIIONENO. c <br /> �i� . CrrvSr2. � <br /> ��-�vSnc��cr� �� � 864 c�r�,�t� , n�v <br /> �LV�GI N� O� �LC il=��— I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> rnoroseouseoFom�oiac APPLICATION AND KNOW THE SAME TO BE TRUE 4ND CORRECT.ALL <br /> NROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHE?HER SPECIFIED HEREIN OR <br /> LEGALDESCPIPiIONOFPROPEP7Y�5HOWNAELOWORATTALHIWOGOPI[51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oi o�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> rnqce�rnx i.o.r+umeEa C RACTORS LAW 18.27 RCW AND 296200 WAC. <br /> 5s3r o04 - o�� -oop(o . Q /f <br /> CONSTRI/CTl RK LORN LENDE{i.FD�RE55.TELEPNONE NlIMf1ER y� � � -1 J l�V I7� <br /> �Yt • ��GNAi IRE DAtE <br /> CITv USMESSLICENSCtlO. <br /> PLUMBING NANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE ND. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) i A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATOPY(WASH BASIN) HE�T PUMP <br /> SHOWER � UNITHEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> � <br /> DISHWASHER � VENTILATION FAN � <br /> IAUNORY TRAY RANGE HOOD � <br /> CLOTHES WASHER WATER HEATER <br /> URINAL WOOD STOVE <br /> DRINKING FOUNTAIN M[TAL FIREPLACE(WOUD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> �ACKFLOW PREVENTERS � GASFIREPLACE i <br /> SINK(SEiiVICE—BAR, ETC.) � GAS RANGE <br /> � GAS PIPING <br /> EXHAUSTFAN i <br /> i <br /> i <br /> � <br /> � � <br /> SUB TOTAL S � SU�TOTAL 5 � <br /> PERMIT 5 PERMIT 5 � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSF.TpALH RGARO��GK SIp�TBACK / / PLANCN[CN LL ER F[[ /���/✓r RECEIPiNO. _ <br /> !C/ � J i i / �f I <br /> usezoy{- � �oTnnen va:nNt e FEES VALUATION FEE <br /> ���� f1 YE5 I 1 NO �T— <br /> OUILDINp � � i�.� <br /> IIEIGIIT LIMITAiIaN� NO Of UW[ILING SIZE Of plOG41 i <br /> y� �N�rs gby S,F. G�za� ��.�Mo��� _ i— <br /> GOUpANCV NO C�SI^RiCS OCCUP�NI LORU BASEMENT � MECIIRNICAL � <br /> �I I fIYES IiINO i <br /> FlRE AIARM H@00 RER504 P�DITIONAL PL�N CNECK i <br /> T <br /> N� oT��Ea � <br /> rme srniNKi en neo�n FERSDN � <br /> 'J� s,nr�nuaoimcsuncr+nnce / I� "7 <br /> TvvEOFcoNst rinNsnrr,no eoer CITY OF EVERETT ruoiicwoaK� � _. <br /> . I � ' <br /> �V - LOCAL SALES <br /> —f.� onTe 5 1 9S TAX CODE IS 3105 TOTAL I <br />