Laserfiche WebLink
AppL�CpTI°�1 FOR CIQWSTRUC""�ON PE�tMIT � <br />TO BE COMPLETED 1N 6LACK INK—PLEASE PRINT <br />--------' <br />BUILDING DEPARTMENT `-- <br />259-8610 <br />❑ DEMOLITION ❑ COMBINATION <br />ARCMIIECTGRDESIGNER IAAIL <br />�1i1ZZr Li > �y✓!� <br />....���n� rnurnnrinn 61ML <br />IFGTWf� SI�ST�M: <br />BUILDIhG <br />cnv <br />�c-G[� � <br />CITV <br />CITV <br />i'LQ. L(-�J C/ G'V� Lvir CiTY <br />MECHANICALCONTRACTOR M1�A���DORESS <br />CIT1' <br />PLUMB:NGCONTRPCTOR MAIL��DRESS <br />CONTRACT PRICE OF YIORK —� <br />__–�—_� <br />ncsGRIBE WORN Ay� SOUARE FOOT�GF�-� �'90LVED <br />❑ ELFC7R�C ❑ <br />❑ MECHANICAL �7 PLU�dBING ❑ SICN <br />ZIP r�w.� <br />Z�P PHONE <br />Z�N PHONE ::i�TE UCENSE M <br />—1'au.vr� a i �� �+uT <br />Z��HONE STA7E ULENSE � <br />Z�� ?HO�IE STATE LICENSE Y <br />��— <br />' PERSON AND �MONE NO. ', J /_ �J s C _ <br />i. ._ .. . i�Ji H.Ci G (� 6 <br />��f /3 �� �� G��.Z � I i HEREBY CERTIFY THAT I HAVE READ ANC EXAMINED THIS <br />� � APPLICATION ANG KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USEOF BUILDiNG �� •�p „�G`� pROVISIONS OF LAWS AND ORDINANCES GOVEANING THIS TYPE OF <br />, : (i7if'Yb�' GC�� <br />WORK Wll! BE COMPLETED WITH WHETHER SPECIFIED HEREIN <br />�e�n� scaiPT�ONOFPPOPERTY� wHee�owoaa?�c��O�P�Es�,l� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GI!�E <br />� BLOCN �F � AUTHORITY ?0 VIOLATE CR CANCEL THE PROVISIONS OF ANY <br />�oT �. CTI�ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />_ �j(y�,�<Lti2G��S �� �' '2 — PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />—� j OWNER OF THIS PP.OPERTY TO PERFORM THE WORK FOR WHICH <br />/37 f, C '� ( J� L'G�'� APPLICATION IS MADE AND I COMPLY WITH ?HE STATE <br />PAFCEL TAX I.D. NUMBE CONTRACTORS LAW 18.27 RCW ANU 296200 WAC. <br />�v , � � ,..,: , — r; /.� �— OC �C� � <br />� <br />SINK & DISP <br />DF.INKING <br />F100R DF <br />OACKFLO' <br />ROOF DR� <br />TOTAL S <br />FOR OFFICE USE ONLY: <br />FRONTSE7B�CK REARSETBACN <br />_1 s�f /C �/6P� <br />USEZONE C LOTAflEA }. <br />s�� �l �/y <br />�_. � i i_ <br />7YPEOfWNSi. NO.O�STOf�� <br />�—l� <br />3iE3� �pG.F � FIRF.SPRINKlER5RE0'D <br />5 � <br />9Z�., .Sf GH2P6 � _ <br />'__......��. � n.n FIRE ALAflh1 REO-D <br />B� pLpNSAPF OVEOBY <br />�_� � <br />onre /_ /� • ��J� <br />OF <br />1TION FAN <br />HOOD <br />METAL F� �t � <br />FIREPLA��NSERT <br />HEAT P_ UMP _ <br />GAS PIP�_ <br />❑xNnuSTFAN <br />SIDE SETBACN PL�N CHECK NUM9tM <br />.u� � �� '�� <br />VACAN7 SITE FEES <br />❑ YES � N� BUILDING <br />OCClI�R6GY NO 0�9WfLlINGU'11i5 " <br />oue� / p�UMBING <br />.-7 — <br />BASEME.vT MECHANICAL <br />❑ YES �NO <br />HEIGHT LIMITATION ACDITIONAL PLAN CHECK <br />�j ' �Iy� � <br />!J OTHEF LV� <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC PoORKS <br />ILOCALSALES <br />TAX CO�EIS 3105 TOTAL <br />--B.I.L'. M <br />1A <br />� <br />PERMIT $ ' <br />70TAL FEE $ I �� � � <br />RECEIPT N0. <br />3c� /OS'S�� <br />VALUATION FEE <br />Z 5 ys� D ` ' ` <br />i <br />i'�i � <br />f � <br />/! � <br />� <br />i <br />i <br />L-C/ � _ <br />.�T <br />2�'� �- <br />�� <br />