Laserfiche WebLink
l.e�- �3 _ � <br /> �3� �' ppp�ICATION FOR CONSTRUCTION PERMIT <br />� CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, VVA 98201 •259-881U <br /> ❑ DEMOLI'lION ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBINO O SI(iN <br /> PROJECT ADDRESS <br /> 5���� - Z5�'7 G���c:. lJ , 4,L�utf L.�`• `1830.� <br /> I pWNER MAILPDDRESS' � ( p /�CITY ZIP /� PNONE l- �j (� <br /> TENRAT 1� ��J DRES�`�Y�n �•� lyp�, 1'T'�- ��l.l.Li �Z� WK PHwTT 1lJ�/� A' �- <br />� ARCHITECTORDESIGNER MAILAODRE55 C�TY ZIP PHONE <br /> ����h' L4.tY1tY <br /> OENERRICONTRRCTOR MRILAODBE55 CITY ZIP PHONE STATELICENSEI <br /> �-rnc �� c�w C,ot.�,n►�'S'�E a ►o M 3' <br /> I MECHANICALCONTRACTOR MAILA�DRESS CITY ZIP ?HONE $TATELICENSEI <br /> PLUMBINGCONTRA�TOR MAILADDRE55 CITV 21P PHONE STATELICENSE� <br />� CONTRACTPRICEOFWORN � <br /> HEATING SYSTEM: AS i7 ELE(.�TRIC ❑ <br /> DESCRIBE WOPKANO SOUARE FOOfAGE INVOLVED , C NT CT PERSON AND P ONE NQO � � �/� <br />� � c� 3o s 6Yq�8/a3 <br /> I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS <br /> P�EL'45E OF BUIIDIN��� APPLICATION AND KNOW THE S.4ME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LA4VS AND OFDi�IANCES GOVERNINO THIS TYPE OF <br /> WORK WILL BE COMPLIED WITN WHETHER SPEGFIED HERE,N OR <br /> LEGRLDESCRIPTIONOFPROPERTY�SHOWNBcIqyW OAATfACM covies� ' NOT. THE GRANTINO OF A PERMIT DOES NOT PRE3UME TO OIVE <br />� �oT�BLOCN oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> � OTHER STATE OR LOCAL LAW REOULATINa CONSTRUCTION OR THE <br /> p� PERFOFlMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br />� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />� APPLICATION IS MADE AN. I COMPLY WITH THE STATE <br /> PARCELTA%I.D. MBER CONTRACTGRS LAW 1827 RCW r D 253.200 WAC. <br /> . � _ 3, o 0 0 o x�� w �/'� �--- <br /> CONSTRUCTION LOAN LEN�ER,ADORESS.TELEPHONE NUMBER Q <br /> i SIGNANRE ,l�'t� � � OATE <br /> �l J <br />� CITV BUSINESS UCENSE NO. <br />� PLUMBING MECHAWICAL <br />� NO. TYPE OF FU(TURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> I WATER CLOSET(TOILEn � A/C—AM.NDLO UNITS—H.P. ' <br /> � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> . �j LAVATORY ASH BASIN) � HEAT PUMP � <br /> SHUWER � UNIT HEATERS—B.T.U. M ' <br />�II : � KITCHEN SINK 8 DISP i CLOTHES DRYERS _ ' � <br /> DISHWASHER � VENTILATION FAN ! <br /> LAUNDRY TRAV ; RANGE HOOD __� <br /> � CLOTHES WASHER � WATER HEATER ' <br /> . URINAL ' WOOD STOVE ' <br /> I . DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BUFNINO) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNINO) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � <br /> � SINK(SEPYICE—BAR,ETC.) � OAS RANQE ' <br />' — � OAS PIPINO � <br /> � EXHAUST FAN / � <br /> i <br /> I� � � - <br /> i ' <br /> SUB TOTAL $ ; SUB TOTAL S ' <br /> II PERMIT $ � PERMIT S � <br /> I TOTALFEE $ � TOTALFEE 3 ' <br /> IFOR OFFICE USE ONLY: <br /> FRONT$ETBA PEAH SETBACN SIUE�TBACK/ � LAN CHECK NUMBER FEE REI.EIPT N0. <br /> / G� ' ��o�.7j <br /> ZS <br /> USEZONE /J�C �OTAREn_ � �� wcnNrs FEES VALUATION FEE <br /> �i J 'Zj( ❑YES ❑ NO tlUILDING /�� �/ �� 'L 9 �� � <br />� HEIOHT LIMITA ISON: / NO.OF OWELLING SIZE OF BLOGRJ. <br /> �Ci UNITS Z(�$Q $.F• L\Urtl4 �" p�UMBINO ` � �� <br /> $ S.f. GARP�+. <br /> OCCUPANCV NO.OFSTOFIES OCCUPANTLOAD BpSEMENT MECHANICAL � (�� <br /> GROU <br /> `L'3 I Z ❑VES NO I <br /> FIRE�IARMREO'D AE/SON ADDITIONALPLANCHECK i <br /> OiHER <br />� FIRE SPRINKLER REO'0 REASON <br /> STATE BUIIAIN�SURCHAflOE SrJ <br /> TYPE OF CONST PUNS PPPFOV o yr CITY OF EVERETT 7l1BUC WORKS ��J� (7O <br /> I / �r¢�+ LOCAL SALES // <br /> N' DATE - � 76 TAX CODE IS 3105 T�TA� �C 7� <br />�I�- <br />