Laserfiche WebLink
__ l�►PPLICATI'�N FOR CONSTRUC ; .�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, Wq 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION � BUILDING C] MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: � j S" �� r� AVQ- �v� �-]r�' �� g 6 <br />s-�u ��l-G, eQ.,,�,- _�„_, _-�--- 9 a I <br />1 <br />� <br />O C�,2 <br />_ a�Qi� �. o ��oZ <br />`'� ��r ° �� -��_.ma_�a Ill�- l�sT75 4Sl-=�y�'] <br />r�ioNe <br />9� ���vwo� �+la 98a37 , 7��-�c��- <br />`pI,Y � Q ���, r ��� N� J / Sf�TE IICENSE / <br />o�.a-� Ci J /I✓E �,'l�. �uZC7� U�cLf�N�'/�'IPl All..e�L .�._.__ <br />� <br />_ _ _'__.. .. �.. _. BIOCK •,• � wrn.nn e[iuw uH 11TTACN TWp <br />lOT l7�- �R ��OF •V�2r <br />� <br />PAi1Lkl TA%I.D. MIAIBER ,�/ / <br />�P�r i�� nJ � st/�/ '(- �a,^f <br />a ioNa�� <br />CONSTRUCIIf��OANLENOER_ADDRESS.TELEPNONENUMBEn � <br />TYPE OF flXTURE Op <br />WA1'ER CLOSET (iOILET) <br />BAPATUB <br />LAVAiORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASHER <br />LAUNDRYTHAY <br />CLOTHES Wf:�4ER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOA DRAIN <br />BACKFLOW pREVEN7ERS <br />SINK (SERVICE — Haa crc i <br />FOR OFFICE USE ONLY: <br />FHONTSETBACK REAR£FTBACN <br />USESONE <br />HEICMT UMITATION <br />PERMIT <br />iOTALFEE <br />IOfARE� <br />NO OF DWEIUNC <br />I;NIIG <br />TYPEOFf,OHSi PL�NSAFPROVED�Y <br />� J� /_ /,. <br />11�' PIIONE ST�TE LICENSE � <br />HEATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br />CON7Af.tPCf�pyµppHONE�q _ <br />1 <br />2s2- Ya32 <br />I HEflEBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORqECT pLL <br />PqOVISIONS OF LqWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WOaK WILL BE COMPLIED WITH WHETHER SF:CIFIED HEREIN OR <br />NOT. TFIE 6RqNTIN6 OF A PERMIT DpES NOT f'RESUME TO GIVE <br />AUTIiORITY TO VIOLATE Oq CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LA'Y11 qEGUWTIN6 CONSTRUCTION OR THE <br />PEHFORMANCE Of CONSTRUCTION. THAT 1 AM AUl'HOqIZED BY THE <br />OWNER OF IHIS 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 � ��� <br />SICNqUiE DATE <br />Citt pUSINE55 LICENSE NO <br />FEE H0. TYPE OF EQUIPMENT FEE <br />' A/C—MiNDLflUNRS <br />� FORCEDAIRSYSTEMS <br />� fiEAT ^UMP <br />_ ; UNIT HEATERS <br />FANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />GAS RqNGE <br />GAS PIpMG <br />S <br />S <br />SIDESETB�CN �PIAN <br />vncnNr SiiE FEES <br />❑VES ❑ NO p��;���Nf. <br />SiZE OF B�OGR� —�— — <br />�313 TiI. riuMniNr, <br />BASEMENT MECI1�NIf.AI <br />❑YES NO -- <br />�OUIIIONAI PI �N f,I1fCR <br />ou�Fn <br />. suir nunonm sunr.iunce <br />CITY OF EVERETT runnr. wnnnc <br />LOCAL SALES ---_ <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL S <br />PERMIi f <br />TOTAL FEE ; <br />�� I flECEIPTNO <br />