Laserfiche WebLink
APPLICATII..�:�1 FOR CONSTRUCti DN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION �/ <br /> 3200 CEDAR STREET•EVERETT, WA 98201 • 259-8810 <br /> f 1 DEMOLITION f l COMBINATION f� BUILDING �l MECHANICAL f l PLUMBING f� SIGN <br /> PROJECT ADDRESS ��� `�. /'L C�`-J <br /> /� <br /> O/W�/NER MPILADDR[SS CIiV DP PHO4E <br /> /� 1��� � ���/� :.�j� !. �/�%( � � • <br /> TENANT MAILApp�+F55 CITY ZiP PIIONE <br /> � � � lr %i �Yr /r� l - rli�r �� ��� i' �` ��' l <br /> ARCHITECT OR DESIGNEP MAIL RODRE55 Gltt ZIP � PIIO4E <br /> GChER/LCO4RIACTOR MA!LPODi1ES5 CI7V ZIP ���ONE STATELICENSE• <br /> r <br /> ,/�'��r�ii'�/ � ��Y% //,, i / � �'iV�ir- /%�''/,-:�li;;;.r. %!�<il� �;%—/ll�t �i�f%�i�i�� /.�/ /"� <br /> �MECM4NICALCONiRACTOR MAILAD�R 55 CITV 21P PIIONE STATEUCENSE• <br /> PLUMBINGCONiR�•CT�O/R MaILADDFE55 piY 21P P��ONE STR7EUCENSE� <br /> CONTRACT RI�F WOBN _ �� <br /> � :, „ ,. � HEATING SYSTEM: f T GAS fl ELECTRIC fl <br /> DESCNIB/EWORKANOSOIIPPfFOOTAGE VOLVEO _ _ CONiACTP[RSONANOPHONENO. <br /> ! ,. 4/ < �'C !� i /' - � � 1� . ./�fi��' <br /> /'L d✓!tY't 6?�� <br /> I HEREB'/ CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSEO USE OFSl11L01NG � r PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> � C{�11/ j � / WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEFlEIN OR <br /> LEGALDESGPIPTIONOFPFWkR1Y�5MONTlBELOWORATTPCMTWOCOPIES) NOT. THt GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ioT eiocK or AU7HORITY 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 BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND � COMPLY WITH THE STATE <br /> PARCELTAXLU. MPER ( CONTRACTORS LAW 78.27 RCW AND 296200 WAC. — <br /> -- � - U��s - ci - ocia- x � . ( , ���=�����% <br /> CONSTRUGTION LOPN LENDEF.AODFESS.TELEPHONE NUMBER --t �� 'r " J <br /> SIG URE pATE <br /> CITv OUSMESS LICENSE N0. <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE NO. TVPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ' <br /> BAT4TU8 � FORCEDAIRSVSTEMS—B.T.U. M E.A. i <br /> LAVATORY(WASH IiASIN) � HEAT PUMP ' <br /> SHOWER ' UNITHEATERS—B.T.U. M � , <br /> t:ITCHEN SINK 8 DISP ; CLOTHES DRYERS ' <br /> DISHWASHER � VENTLATION FAN � <br /> LAUNDRYTRAY RANGEHOOD ' <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPL.4CF(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOO�BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE ' <br /> GAS PIPING � <br /> � EXHAUSTFAN ' <br /> i <br /> 1 SUBTOTAL 5 i <br /> SUBTOTAL S i <br /> PERMIT 5 i PERM;T S � <br /> TOTALFEE $ � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FfiONT$ETBRCK PE�A SFTOACK SIOE SFTBRCK PLAN C�CK NI�J�ER FEE�� �L, AECE�; 1/ � <br /> ���/5 �� <br /> FEES VALUATION FEE <br /> USE 20NE LUT PRER VRCANT SITE — /J i <br /> f1YE5 n NO pUIL01NG 2 Q� 2 /'� � <br /> HEIGHTLIMITATION UNITSFDW[ILING SII��BLOC�41 � ��, � <br /> ���-•y� PLtIM81NG <br /> �i1 r�^T/ i . <br /> 0[:CUPRNCV NO 015i0RiE5 OCCUPANTLOAD BASEMENi M[CI!�NICPL � <br /> GPOUP <br /> 2 A10 G �6G ;+cYEs �, �o ; <br /> ADDIIIOVRL PLAN CH6GK <br /> FlPE PUR�M^fiEO'D RGSON � <br /> IVD ' <br /> OiM2R � <br /> FIRE SPRINAK4IlER REdU RE�SON STrITE f1UILDING SUfiC11ARGE L �,_f�✓ <br /> 1�/ � <br /> tvreoFco�+st rv.nsnrrnovEoor CITYOFEVERETT ruoucwonres <br /> � LOCAL SALES ��/� ;� ) <br /> oqTE TAX CODE IS 3105 TOfAL <br />