Laserfiche WebLink
r. <br /> APPLICATIG.�1 FOR CONSTRUCT�ON PERMIT <br /> CITY OF EVERETT• BUILDIN�,;. DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-9810 <br /> f-I DEI�JLITION Il COMBINATION (-1 BUILDING vf MECHANICAL rl PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> L 1/D c'� GtJ e .—s»a.Qf_ Av£ . Ed£Q£;T <br /> L�Ep M�ILAUpRE55 ptt Im PHONE <br /> rJo��.✓ /-�.o,(��.✓S B/o Coc,cr✓ �vE F'�£2£;r 2sZ-s"z6� <br /> IEN�NT MRIL�DDRE55 CITY IIP i9�ONE <br /> JEiI/i✓✓ �Mi rH /�n� /,I�E Tiv�02� l4r/� �fj Zo/ 2S2 - �/76S <br /> �RCMITCGT OR DESIGNER MPII�ODRE55 �ITY )IP PNONE <br /> GENERnICONTMCiOR M�ILADDRE55 CI'V IiP PiION[ GUiEIICGNSE• <br /> McCNANILAL CONTRRCTOR MFII�DORESS dTY 71P PIION[ SiAiE UCF.NSE� <br /> PWMBINGCONTR�CIOR MRILILDRESS CITY 21P PHONE STATEIICENSE� <br /> GONIRIICT GRICE GF WORK <br /> /��.P/, ° � HEATING SYSTEM: f rYt�aAS fl ELECTRIC rl <br /> OESCRIBE WORR AND SOUARE FOOT�GE INVOIVED CONTAGT PERSON 1N0 PHONE NO <br /> '%� pLAGL �oS �/�e.IACE L '��,y/ Z.S9 B/B7 <br /> •�i/ -i J � <br /> I HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED THIS <br /> F110�POS7EDUSEOFBUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> C£S PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE CpMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IEGALDESCR�PTIONOFPqpPERTy�SNOWNBEtJWpq�TT�CNiWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tot aiocK oc_ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATINO CCNSTRUCT�ON OR THE <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV TFiE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICFi <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX ID.NUMBER CONTRACTORS LAW i CW AND 296200 WAC. <br /> CONSTRUCTION LO�N IENDER.�DIXiE55.TEIEPHONE NUMPEP .�� b �Z� —S�� <br /> � � SIGRI11V11E DRTE <br /> diY BUSINF.SS IICENSf NO. <br /> � � PLUMBINO MECHANICAL <br /> � � NO. TYPE OF FlIITURE OR ITEM FEE NO. TI/PE OF EpU1PMENT FEE <br /> WATERCLOSET(TOILEn � q/C—ARiNDL6UNfTS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. ,$M E.A. ; <br /> LAVATORV(WASH BASIN) HEAT PUMP <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK d DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � VENTiLATION FAN � <br /> LAUNDRYTRAV ; RANGEHOOD ' <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE <br /> GAS PiPING <br /> EXHAUSTFAN � <br /> � <br /> � <br /> � <br /> SUBTOTAL 8 SUBTOTAL S 'v <br /> PEhM1T $ i PERMIT $ r V� <br /> TOTAL FEE 5 � TOTAL FEE E r S'� <br /> FOR OFFICE USE ONLY: <br /> fRONTSFTpACN Ri�RSFTPRCK $IOESETP4CN Pl�NC11ECNNUMAFf1 / �fF fiECFIPTNO. <br /> ��� <br /> useznNe iotnnea vncnN�srte FEES VALUATION FEE <br /> _ IIVES fl NO p��IIDRIG i <br /> HEIG14lIMI7�TION NO OF UWEILING SIZE 0�OtIX;T <br /> ❑NIIS ' <br /> PLUMPIN(i j <br /> OCCUMNCV NOpiSIpRi[5 OCCUPRNiLO�O BASEINENi MFCII>NICAL i <br /> GROUP <br /> IITES I� NO — <br /> FIREQARMREOD {iER50N �DOIIIONAI.PlANC11fCN i <br /> on�cn ' <br /> FIPFSPRINKIEPRFOO RFA�ON i <br /> srnie eunnrvc svnr,���ncc <br /> I <br /> tmEorr,oNs� vinNsnrnnovFnnr CITYOFEVERETT runnr.worKs <br /> LOCALSAIES — -- <br /> i,q7t TAX CODE IS 3105 7oTal <br />