Laserfiche WebLink
APPLICAT101�7 FOR CONSTRUCTION PERMIT�,�}� <br /> CITY OF EVERETT• BUILDING DIVISION ��r <br /> 3200 CEDAR STREET•EVERETT,WA 98201 •259-9810 �J—" <br /> fl DEMOUTION fl COMBINATION fl BUILDING f–I MECHANICAL AC PLUMBING f 1 SIGN <br /> PROJECT ADDRESS • <br /> 'S l- v /' � <br /> owHe9 Mni �ooness cm zir m1ONe _ �:3 !�"� <br /> �/ y n <br /> /Y(1/�Ia-7. tr/.� n J G (" '✓ !t . �f _ <br /> IEN�NT M�IL RF.SS CITY 21P PNONE <br /> �PCPoIEGT OR DESIGNER M�II.����E55 CItY Zi� �NONF. <br /> GENEiUIWNTRRGtqi MAIIADDPE55 G�iV )iP P�IO4E SIATEUCENSE� <br /> MECNANILRLCONiR/.CT01i M�IIADDRE55 Cltt ]IP P110N[ STQELICFNSE• <br /> MU�G60N1R�CTOB MMI.AppRE55 Cltt IIP PIIONE ST�iELICENSE� <br /> cor�rn�crraiceorwonK HEATINGSYSTEM: GAS �tELECTRIC fl___ <br /> p�S�PIBE W(MK�NO SOU�AE FOOT E INVOIVED CONTACT PEPSON�ND 1'NONE NO -- <br /> OLm � <br /> �vO � <br /> � / I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> sEousE oFeuitoma PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEG�lOESGRiP7�ON OF PMd'ERN 15NOVM BELOW OR�TT�LH TN'O COflES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM� TO GIVE <br /> t07 e�oac oF 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 AUTHORIZEO BV THE <br /> OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AN�296200 WAC. <br /> F�RCEL TiVf 1.0.M1E�BER <br /> � y- Y � <br /> �pl1$T{IUCTION lON!IENpER.�DD�E55.TElEF110NE NUMBER x l �-- <br /> 51 �IURE U D�t[ <br /> CITY BUSME55 LICENSE NO <br /> �V�� MECHANICAL <br /> ►p, TYPE OF FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) � A/C—AMNDLGUNRS—H.P. ' <br /> BATHTUB � FORCF.D AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP ' <br /> SHOWER � UNITHEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP CLOTHES ORYEHS T <br /> . DISHWASHER VENTILAI'�ON FAN ' <br /> UIUNDRY TRAV � RANGE HOOD � <br /> CLOTHES WASHER WATER HEATER <br /> URINAL ' WOOD STOVE <br /> ORINKING FOUNTAIN i METAL FIREPIACE(WOOD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSERT(WO00 BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> � SINK(SERVICE—DAR,ETCJ GAQ RANGE <br /> GAS PIPING <br /> y EXHAUSTFAN <br /> i <br /> i <br /> i <br /> SUB TOTAL $ � <br /> SUBTOTAL S ��� <br /> PERMIT $ i PERMIT E � <br /> TOTALFEE E T LFEF E , <br /> FOR OFFICE USE ONLY: � � <br /> �« ner.Firr Ho <br /> fRONTSFTPACN PF�RSFTBRCN SIOESETPACN �IANCI .k i pfP / — <br /> CL / <br /> � V <br /> VAIUATION FEE <br /> USEIONE IOT�REl1 VAUNLSIIF. <br /> I IYES I1 NO pU11piNG � <br /> NEIGIIT LIMII�PON NO OP OWELIING SRE O�9lIX;T � � <br /> UNI1G PLUMOING ✓ _ F _ <br /> � � �1 -- ' <br /> OCCVP�NCV NO M SIORiES OCCU�ANILOAO B�SEMEM1L M[GInMf.�l � � 1� _ __ <br /> GRWP � —— <br /> IlYES i� NO <br /> ADDI I ILNAI PI AN C�� CN <br /> FlRE�L�Ru REOD nGn50N <br /> onrtn <br /> fIPESPRINNIF:RRF:OA �F�90"1 c�p�E001L01NC5URCNRRGE <br /> trreorr.o�+si rinr�snrrnoverer CITYOFEVERETT ^��A��r.wonKs _ <br /> LOCALSALES J <br /> ��q�i TAX CODE IS 3105 TOTAL —1-- <br />