Laserfiche WebLink
,,,� _ <br /> APPLICATIOrI FOR CONSTRUCT�ON PERMI'r <br /> CITY OF EVERETT•BUILDING DIVISiON � <br /> 3200 CEDAR STREEi • EVERETT,WA 98201 •259-8810 <br /> I-1 DEMOLITION (l COMBINATION f�l BUILDING f�ECHANICAL y� PWMBING fl SIGN <br /> PROJECT ADD ESS /' <br /> � L Z S/ �CJ�i"l � � ��F �c1G ' �T ������ <br /> pNM q M�IL�ODRE55 CITY 21P PNONE <br /> .�,���s GLsa�, s, .d�-1Ls 5� o� 52�5�5rG'�.'yz�z�7� - <br /> 1EN�Ni MIIILAOOPF.S �LITV ZIP P��ONE ' <br /> J��s �l�- ---- <br /> ARCMITF.Gi OR OESIGNER M�IL ADDPESS Gltt ]m PHONE <br /> �6 �l � <br /> GEN[RPICONTPPLTOti MRILRDDRE55 CItV ZO` PiIONE STRtEIICENSE� <br /> J �a �Y c5 � ��C� ��� 7yZ-'��7� 6�.�r���R Pl��S i�� <br /> MECN�NIGALC06TR4CTOR MML�DDPE55 Cltt 21P P110NE STATEULENSE� <br /> no,�.�L �-- - . -- - <br /> PLUMBM�CONiP f,TOP nILRD�R1E�5�5 f J CIfY ZIP PHONE $TqELIGENSE� <br /> ��I�� '-�f> �«� l`''�, lw�L1(�'tu7 <br /> CON!N�GT,P,RIp EOFWORK <br /> Sa�"7 1 DO� , C�G' HEATING SYSTEM: fl GAS I� EIECTRIC fl <br /> DESCPIOE �ND SOU�RE FOOT�GE INPOL\EO CONT CT PERSON�NO FIIONE NO. <br /> . r��✓Yj � <br /> �n-C�2.�:4't �' �: .,� <br /> �'7� O�'�L r�t � ��� _ I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br /> �� - APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> pnpN� , 0 6UILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HIS TYPE OF ' <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> �ea�oe IPTIONOFPROPERfV�SHJWNBELOWORATGLMTWOCOPIE51 NOT. THE 6RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF_ AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I Aht AUTHORRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PARCELTA%I.D.NUMBER CONTRACT LAW iB27 RCW AND 2962/00 WAC. <br /> �,�., �q (/ (/ /� <br /> CONSiRUCPON IO�N LERDER.�DOPE55.TFLEPHONE NUMBER '�j7/i[(/..� `� `J�� /a�f�-/-��^- <br /> SIGN/�TURE OATE / <br /> / <br /> . �CITV BUSMESS LILENSC NO <br /> � PLUMBINO � MECHANICAL <br /> NO. TYPE OF FlIITURE OR ITEM FEE NO. TVPE OF EOUIPMENT � FEE <br /> ' WATERCLOSET(TOILET) � A/C—lVHNDL6UNITS—H.P. <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) HEAT PUMP � _ <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP i CLOTHES DIiYERS <br /> DISHWASHEH � VENTILATION FAN ' <br /> UUNDRY TRAY ' RANGE HOOD i <br /> CLOTHES WASHER WATER HEATEF � <br /> URINAL WOOD STOVE ' <br /> ORINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) �_ <br /> BACKFLOW PREVENTERS i GASFIREPLACE � <br /> SINK(SERVICE—BAR,ETC.) GAS RANGE ' <br /> GAS PIPING ' <br /> � E%HAUSTFAN � <br /> � . � <br /> � ; <br /> � <br /> SUBTOTAL S � SUBTOTAL $ i <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE 5 � TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> iRdlT SFiPRCN REM SF.TPRCK SIDE SETBACN PIRN CIIECN NUMOEII �CF �iCFIPi ND <br /> USEZONG ioienen �AC�NISIIF. FEES VALUATION FEE <br /> f I YES i i NO pUIt01NG i <br /> HEIGIITLIMIt�TION NOOFUW[LLING SIIEOFBLDGrtI <br /> i <br /> IINIf$ PIUAIOMC <br /> -- I <br /> OCCUVRNCY NO 04 510RI[5 OCCUPANT LORD BASEMENL MFCHANIf.AI i <br /> GROIIP <br /> IIYES 11 NO <br /> FIRE�URMRWO RFB50Y ADDIIIONAI.PIRNG�If.CN � <br /> T <br /> O1NER � <br /> fIRF.SPPINMiERRF.O'❑ RFA40N � <br /> STR1E OIIIIpINC,SURCII�RGE � <br /> �"_ <br /> ivrEorcoNsi rinNsarrnoveoor CITYOFEYERETT rnnncwonHs <br /> LOCAL SALEF. --�'— <br /> oATE TAX CODE IS 3105 TOTAL � <br />