Laserfiche WebLink
� � <br />APPLICATIOrI FOR CONSTRUCT.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREE'i • EVERETT, WA 98201 • 259-8810 <br />fl DEMOLITION fl COMBINATION yr tiUIIDING f-1 MECHANICAL rl PLUMBING fl SIGN <br />PROJECT ADDRESS /7� I��,� S,.0 Sv�/ <br />L <br />OWNEP M�ILAO�RESS ��7y <br />Iv� GC.""�—G I � � � <br />ZIP PMONE <br />CITY 21P <br />!�'i5�-9� <br />PLUMBING CONTRAf,TOR MAIL RD�FESS Citt ZIP PHONE STATE UCENSE • <br />CONTRACT <br />WORKAN SOUAREFOOTRCaE <br />I .. I/g � �J-.. <br />LEG�L DESCRIPTIIXJ OF PROPERTY (SHOWN BE <br />LOT� BLOCK <br />F41(stl�. F.luJ n <br />CONSTRUCiIONtOANLENDER.A�ORESS.TEIEPHONENUMBER <br />PLUMBINO <br />NO. TYPE OF FlI(TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />�SITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, El <br />FEE <br />� SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE 3 <br />FOR OFFICE USE ONLY: <br />FRQNT SE7PACN REAR SETBALN SI�E SETBACN <br />USE 20NE !AT PREA VALANT SITE <br />IIYES iiNO <br />HEIGIIT LIMITpTION N0. OF DWELLING SIZE OF BIDG/fl <br />uNirs qG SF Gaz_ <br />OCCUPANCY NO 0�5(ONiES OI:CUPRNTLOAD BASEMENi <br />I I I I N/d I nYEs n NO <br />HEATING SYSTEM: f�l GAS fl ELECTRIC rl <br />CONTACT PFRSON AND PMONE NO. <br />I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS <br />APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEPNING 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 REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CpNSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS M AND I COMPLY WITH THE STATE <br />CONTRA ORS LAW 8 7 RCW AND 296200 WAC. <br />x � �_ <br />SIGNATU DRTE <br />CITY BUSINE55 LI NSE NO. <br />MECHANICAL <br />N(�� TYPE OF EpUIPMENT FEE <br />A/C — A/HNDLG UNfTS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />UNIT HEATERS — B.7.U. M � � <br />CLOTHES DRYEFS � <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE PNOOD I <br />GAS FIREPLACE <br />GAS RANGE <br />EXHAUSTFAN <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />[1/ . �a O <br />PIANCIIEC�UMpFR I FE�/� I RECFIPTNO. <br />� v�7� <br />BWlflRlf. <br />PLUMPING — <br />MGCIIANICAL <br />PODI I IONAI PI�N CIIFCK <br />OTHER <br />STATE 01➢LDING SIIRCHARGE <br />CITY OF EVERETT runuc wonKs <br />LOCAL SALES <br />TAX CODE IS 3105 TO7AL <br />