Laserfiche WebLink
APPLICATIO� FOR CONSTRUCT�ON PERM1�/ <br />CITY OF EVERETT • BUILDING DIVISION {�C���� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 � <br />I l DEMOLITION fl COMBINATION �l BUILDING �MECHANICAL � 1 PLUMBING f l SIGN <br />PROJECTADDRESS �In UI�C-�I�I� PC�J�- <br />_� <br />owr+en rnni�aooncss �iTM <br />q vi�6iiJ�A � <br />f.ItY <br />�vne�-rr- W a� qg2o � <br />►� qS�� zSz�{ I <br />RRGMIT[CTORDESIGNEq MPII�DpRE55 CITY IiP PHON[ <br />GENEOAICONtR�C10R IUAIIpOD�E55 QiV jlP PIION[ GfRiELIC[NSE♦ <br />MECN/A�hICAL COMN*RACTOR Mnil ADDRf:SS CITY 2iP PIIONE STATE LICENSE • <br />V'�/.� � C`� <br />PIVMBINGCONiRAf,tOR MAILADURE55 diY zlP PMOYE STATELICFNSF• <br />DESCFIBE WORK 4Np SOIIPRE GppTAGE INVpIVED <br />oF <br />iec�� oescnmrior+oF rnori <br />LOT ALOCK <br />'_I! � <br />ISNOwN BELC <br />CONSTt1ULT10NLOANIENDEII,RDDRE55.TE1[PMONENUUB[P <br />TYPE OF <br />WATER CLOSETi <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 I <br />DISHWO,SHER <br />LAUNDRYTRAV <br />C�OTHES WASHE <br />UFINAL <br />ORINKING FOUNT <br />FL60R DRAIN <br />BACKFLOW PREV <br />SINK (SERVICE — <br />FOR OFFICE USE ONLY: <br />fRONi SFif1ACK RF.AR $FT�ACN <br />USE 20NE <br />HEIGI�T LIMILR110N <br />OCCUPANCY NO Of <br />GROUP <br />f IRE �LARM REO D <br />fIRF $PRINNI ER PE( <br />1VPF Of f,ONST <br />IOiAREA <br />HEATING SYSTEM: I i GAS �ELECTRIC f I <br />CONTACi 1'[RSON RND PIIONf Np <br />I HEREBV CERTIFV THAT I HAVE READ AND E%AMINEO THIS <br />APPLICATION AND KNUW THE SAME TO �E TRUF AND CORRECT ALL <br />PROVISIONS OF LAWS A��D ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL B� COMPL�ED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br />AUTHORITY TO VIOLAi� OR CANCEL THE PROVISION OF ANV <br />OTHER STATE OR LOCAL LA`N REC.JLATING CONSTRUCTION OR THF <br />PE�iFORMANCE OF CONSTRU:TION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROFERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACT RS LAW 1827 AND 296.200 WAC. <br />� //-/ 7- 4� <br />SIGN lIR - �qJE <br />piY OUSME55 LIC[NSf. Np <br />OR �TEM FEE NO. TYPE OF EpUIPMENT FEE <br />' A/C—A/HNDLGUNITS—H,P. <br />; FORCED AIR SYSTEh1S — B.T.U. M E.A. <br />11EAT PUMP <br />' 2 UNIT HEATERS — B.T.U. f.A <br />CLOTHES DRYERS <br />VEt�.�TILATION FAN <br />' RANGEHOOD <br />WATER fiEATER <br />WOODSTOVE <br />i METAL FIfiEPLACE (WOOD BUPNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />' � � GAS FIREPLACE <br />%�) GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SUD TOTAL 5 � <br />PERMIT 5 i <br />TOTAL FEE S <br />SIpE SETAACk Pl4N <br />NO OF UWE!LNG <br />IINIIG <br />nnrE <br />10A0 <br />VAC�NISRE <br />I rv[S I : NO <br />SIZE Of 9LOGRI <br />I1YES li NO <br />CITY OF EVERETT <br />LOCAL SALES <br />TA% CODE IS 3705 <br />ominiHc <br />PLIIMOING <br />MFCNANICAI <br />RDDIIIONAI RGNCHfCN <br />OIHFR <br />StAIC OURDING 5'If1CN�qGE <br />ri im ic wonKc <br />TOTAL <br />([f <br />SUB TO PAL 5 G�O 15 ��'U" <br />PERMIT 5 �5 � ,�'— - <br />TOTAL FEE 5.�' a� L", � � � <br />fiFCE1Pi NO <br />