Laserfiche WebLink
� APPLICATI�1 FOR �ON�TRUC�bN PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98207 •259-8810 <br /> ❑ DEMOLITION ❑ COIYIBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: ��j �� � ,�� T(� �%�F�T x <br /> C/.�uRcrf o� t�iv�nrFMA+.� zyoz �c�,�n-, rr �-dc � �/���1 r,vR-9lr�or �� <br /> ONTlEP • MiVL�00FE55 CIN Ii �P1qN <br /> cu � �rrE �o�p ay� s�-v� �� Z <br /> 7 T . MNIADDi1E$5 LITY 21 PNONE <br /> - as � �� �c.��- �o — -a� <br /> TECTOqDE51 ER I.WLADORE55 CITY ZIP E � NHC �/- <br /> �� GENERAICONTRIICTOR MNLADDN� � �2 �ITY � ZIP��� ��� �NpE ,St�TELICEN��� <br /> _N A- <br /> MEC/N�AtUCALCONTMCTOR MAIL�DDNE55 qiY 21F PHONE STATELICENSE� <br /> / � � A / <br /> PLUMB O!1�TOR ��FDDRESS � � CI���� IIP _n/ PHONE STATE LICENSE• <br /> ��S <br /> c T vrace ov wonK <br /> C"—CorV OF CL ID� � " EI�2cI HEATINGSYSTEM: ❑GAS � ELECTRIC ❑ <br /> � BE M/ORK 11 SOU RE�OOTApE MVOLVED C'hVT�C(FERSON�ND PMONE NO <br /> z � <br /> �` , E� �+E r� �d <br /> aN��� Ll)CS S//JE /v� ( � ��.�(j,L � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> raovoseo usE oa euurnrxa � APP,�IC/1TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> /�tD fF���n u� c�6tlfSIONS OF U1WS AND OROINANCES GOVERNING THIS TVPE OF <br /> C�rEN �'�(' �}c/ST/N C� ���"� lJ� � y�aRK WILL BE COMPLIED WITH WHETHER SPEGFIED HEREIN OR <br /> LEG/�LOESCRIPTIONOFP{IOPEPTY(SIIOWNBELOWOR�T7/iCM7YpCOVIES) �T. THE ORANTING OF A PERMIT DOES NOT PRESUME Tp GIVE <br /> �oT 1�. �� i9 eiocK �_�s�oF ILE� LAf�{D �5 � AUTHORITY TO VIOUTE OR CANCEL THE PROVISION OF ANY <br /> ' � � OTHER S7ATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> ��(7'GIfEL L Ll�N O�TM��.JJ£11t.nfT U.`5 F/tsT PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> r���-n,v�v —rp u�,,.c�� Va�- � / yyoN�dµ �Wq, OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> , L �, APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> v��i�x i.o.riur.reEa CONTRACTORS LAW iB27 CW AND 296200 WAC. <br /> a���b �- �030 -0� , /y�� � / <br /> ' CONSTIIUCTIONIOIWLENDER.ADORE55.TELEPYIONENUNBER SHiN�U��O� (J IIL���(J <br /> !T oa � � 4a_ <br /> . an eusr+ess��ceNse r+o. <br /> � VLUMBINO MECHANICAL <br /> NO. TY OF flXTURE OR REM FEE NO. OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn ' A/C—AMNDLO UNITS � <br /> � BATHTUB ; FORCEO AIR SYSTEMS ; <br /> UVATORY(WASN BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS ' <br /> KITCHEN SINK 6 DISP � CLOTHES DRYERS � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ; <br /> CLOTHES WASHER i WOODSTOVE � <br /> URINAL ' MEfAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN i FIREPIACE INSERT(WOOD BURNING) i <br /> FLOOR DRAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS HANGE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> � IXHAUST FAN �_ <br /> � �_ <br /> i � <br /> SUB TOTAL S ; SUB TOTAL f ; <br /> PERMIT S � PERMIT f � <br /> TOTAL FEE S ' TOTAL FEE S ' � <br /> FOR OFFICE USE ONLY: <br /> FRpITSEj�ICK_�J RE�RSET&1CK J SIDESETB�CN / PlANC11�NUlAB6R FE�� ? RECEIPTNO <br /> v� � <br /> � �.i <br /> USE ZONE ��� l0T�REA VACANT$ITE FEES VALUATION FEE <br /> ❑YES ❑ NO BUILOINC p � � <br /> NEIGHTUMITATION , NO;TOFDWElLIN6 SIZEOFBIDC?I 1-1 i <br /> � I30 S�F D� P���MBING i <br /> �O�C.�CUPANCY NO Of Sf(MtlES OCCUPANT LO�D B�SEAIENT MECH�NIGeL � <br /> �� I ❑YES NO � <br /> �OOIiIONAL PIAN CHECK i <br /> FIRESPRINKLEppEO'D REASON i _ <br /> O1HER � <br /> i <br /> FlREALAFMREO'D REASON —_ I <br /> STATE BJIIDING SURCH��OE ��� <br /> TYPEOFf,ONST PL�NSAPPFOVEDBY CITYOFEVEREIT PIIBI.If.WORKS � <br /> J�� LOCAL SALES —J— <br /> �hI DATE 6 TAX CODE IS 3105 TOTAL � <br />