Laserfiche WebLink
ppPLICATIOr�I FOR CONSTi RUCT.aN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8810 <br />fl DEMOLITION �4 COMBINATION rl BUILDING I-1 MECHANICAL �l PLUMBING fl S1GN <br />PROJECT ADDRESS , <br />� _..r c�o,.�i c�ZGs ; s�IF��'T u1Pk �8.20� <br />OWNER MML�DDf1E55 w. ... ...___ <br />BREn�T �.a�4�-tSER b�F�3 BERK�rtiR.E �R �lE.iC.�rr �aPr 98zo3 �d�� 3 <br />1EN11NT M�IlAODRF.55 CITY TiP PNONE <br />ARLHITECTOROESIGNEA M�II.ROORE55 Cltt ]IP PHONF <br />-- ---'- - -. —' �.r t..�n�-'e- �.�d o.�....�a .SSS�OS_31 <br />cnr zm <br />MECH�NICQCONTRACTOR'• M�R�D�R�': LITY ZR' PIIONE STAiFUCENSE� <br />NORIZON ."��•�� /• �'���1��^� 7V5-39.�o T�TEIICENSEr <br />PWMBINGCONIR�LTOR 'MAILR�DFE55 LIIY ZIP PNONE 5 <br />_ . .. _ . _ . . .. .. a •f41-eaa4 <br />�� �r„� � .�ti� „� .ti <br />DESCRIBE YIO�K �NO <br />��i_. . •�.... <br />INVVLVCV <br />lE(3ALDESCRIPiIIX� OF PROPERTV (SHOWN BELOW pO�R <br />/YI LOT y BIOCK � OF�Y <br />D�vis��.+� � <br />_ 9�90 �.anl �003 �O�O <br />� LY.��rE.�i � ?�ll� GUB�TI" <br />CONSTRIICTIOM LO�N IENDER. ADDNE55. TELEf'NONE NUMBER <br />NO. TYPE OF FlXTURE OR ITEM <br />(� WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />Q� SHOWER <br />KITCHEN SINK 8 DISP <br />Q DISHWASHER <br />�-• LAUNDRY TRAY <br />CLOTHES WASHER <br />�- URINAL <br />,d- DRINKING FOUNTAIN <br />.�- FLOOR DRAIN <br />FOR OFFICE USE ONLY: <br />fRONTSETPRCK REM SF.TB�CN <br />USE 20� f <br />�- L <br />IIEIGIIT IIMIT�T10N / <br />or r,orvs i <br />"j�-n� <br />� <br />3 <br />� <br />� <br />sioe sErencK j <br />i <br />HEATING SYSTEM: � GAS "l ELECTRIC fl <br />CONiACT PERSON AND PHONE NO <br />1 HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW rfiE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATINd 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 />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />x. �_...�' t�-- 9-.7.9—�5 <br />SIf,N�TUPE �TE <br />CITV BUSINE55 LILENS[ N0. <br />110. TVPEOFEGUIPMENT FEE <br />0' A/C—AMNDLGUNfTS—HP. <br />.1' FORCEDAIRSYSTE`.�S—B.LU. M E.A. <br />!� <br />=n�cna — c <br />ES DRYERS <br />ATION FAN <br />HOOD <br />HEATER <br />STOVE <br />FIREPLACE <br />P EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT S <br />TOTALFEE S <br />/7 ' <br />( <br />PUNCIIE�CNNUMBFP F[Fl^ / / AF.f.fIPTNO <br />�. <br />IOTMEA VPCANi51f[ ��c� <br />i�ves nr�o owioiruc <br />NOOFOWELLING SIZEOFBIIX:RI <br />IINI�S Q( "�Z �SY LiviaiG t p�UMflING <br />00 5 i�i4/+ V - <br />OCCUPANiL040 BPSEMFNt �� MEGNRNICRL <br />'� a I1vE5 '�^+� - <br />ADDI110NA1. CIAN GI(.CK <br />f1FASON <br />OIHER <br />RF�SON <br />SiNE [1UIIDiNf SURf.11AfiGE <br />vinNsnrrnpvFoor CITY OF EVERETT runncwa�Ks <br />�J � LOCAL SALES <br />..._, i., /._ /a c TAX CODE IS 3105 TOTAL _ <br />