Laserfiche WebLink
APPLICATiC _J FOR CONSTRUC7 .JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />❑ DEMOLITION [� COMBINATION ❑ BUILDING ,1'J MECIIANICAL ❑ PLUMBING ❑ SIGN <br />PROJECTADDRESS: 4(�� I 1i00 �Z(�i �O ( LL�--��� C(R7�y <br />•��•-•• ,,,� p cnr nr <br />�' \ ���f <br />�ncwtteTOAoesier�n u�nwbrtess cin —�-;ii•- <br />r.nv <br />MECH�NIC�I <br />M�II <br />GONTRACT PRICE OF NO� ��/, J <br />� <br />DESCPoEE W011K �NO SOU�NE FOOIAGE INVOtVED <br />_ � i� l-(��ICt <br />WqPO5E0 USE OF BUIldNO <br />LEOAL OESCPIPTIp! OF %pl'ERrY (�bWN BEIOW <br />LOT BIOCK OF_ <br />VJI I.O./AMBER <br />CONS111UGTION IOAN LENOER.I�DdiE55. 1ELEP110NE M1MBE11 <br />PLUMBINO <br />NO. TYPE OF fl1(TURE OR ITEM FEE <br />I WATER CLOSET(TOILETI �— <br />SINK 8 OISP <br />UUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />ROOR DRAIN <br />BACKF'AW PREVEM <br />SINK ISERVICE — BA <br />SUBTOTAL f <br />PERMIT S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FIIONTSETBACK pE�PSFTB�CN <br />USE 20NE <br />HEIOHI UMT�itON <br />oqc�u+cr r�o a siancs <br />lO1�REA <br />NO OF OWEl4NG <br />UNIfS <br />9DE SFiB�ck <br />I ❑YES ❑ HO <br />S12E OF BIOGR I <br />❑YES ❑ NO <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />rIIONE � St�1Et10EN5E� <br />rnor�E <br />li�' PI�ONE STAfE IICENSE • <br />fiEATING SYSTEM: � GAS O ELECTRIC ❑ <br />CONUC f Pfi15p11 R!p PIIONE NO % <br />�--�1 A�"� i�i1, f � L_ <br />I HEREDY CERTIFV THAT I HAVE READ AND EXAMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT AlL <br />PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIfIED HEREIN OR <br />NOT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTIIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER SiATE OR IOCAL LAW RE6UUTING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTMORI2ED BY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MAOE AND I COMPLY WITH THE SiATE <br />CONTRACTORS LAW �T/ R AN 96.200 WAC. <br />x � �O (1 �-- <br />SICN�IIIOF D�TE <br />dfY p1151NE55 LN:ENSE NO <br />NO. � 7YpE OF EOUIPMENT <br />rv�. —NnnuW urv113 <br />� FOIICEUAIRSYSTEMS <br />I1EAT PUMP <br />UNIi HEATERS <br />CLOTNESORYERS <br />MNGE HOOD <br />WAiER HFATER <br />WOOD STOVE <br />MF�AI. �IREPIACE (WOOD BURN <br />GAS <br />GAS <br />PI �N �I ICCN <br />OIIIIDItIf. <br />I4UMpMq <br />MEf,I1�NIU1 <br />�OUII IONq PI �N C11f f.N <br />o��2n -- <br />sui e nun un+r, si mn uncc <br />runnr, wnnxa---- <br />TOTAL <br />PERMIT <br />�EF IREf.E1PfN0 <br />