Laserfiche WebLink
� � <br /> APPLICATI�a+I �OR CONSTRUCTrON PERNi1T <br /> CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEUAR STREET• EVERETT, WA 98201 •259-8810 <br /> fl DEMOUTION Cl COMBINATION rl BUILDING fj� MECHANICAL �l PLUMBING fl SIGN <br /> PROJECT ADDRESS , <br /> / O 3FG � v< S� ��' �=� t� " �' <br /> OWNER M�ILAWRE55 � CITY 21P PM <br /> Sf" ..�..� s ,.H 'NY, � � - <br /> 1ENRNT MRILADORESS CITY / 21P PH NE <br /> /YoT�I� n�.e L' !: A�✓. .^. ib `� ?o. J9R��S 3k 33 �s' 37S/ <br /> ARCHRECTOROESIGNER MMI�UDRE55 GUY TIP PHONE �T� ���-I �C <br /> � (�i7� f G(� F � T ��4tio� zol 75'z9c7s ,�' <br /> � prYn n � �e ',1 �°6 N �.rNi a.,•� ec< .,� r, <br /> GET�QCON BAGT MAILADORESS GITY 21P PMONE S�ATEI.ICENSE� <br /> MECHANICALCONTRACTOP MAIIADDRE55 dN ZIC PI�ONE STATELICENSE� <br /> PLUMBINGCONTRRCTOR MAIL�DDRESS CITV ZIP PHONE STATELICENSE� <br /> CONTRA PICEOFWOF�� <br /> �• ��p— HEATING SYSTEM: f l GAS rl ELECTRIC fl <br /> � DESCRIBE YlORN AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AN�PHONE NO. <br /> � . � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL - <br /> � , . PROPOSED USEOF BUIL�ING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> IECa�L0E5CRIPTIONOFPROPERTY�SHOWNBELOWORATTACHTWOCOPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � �ot BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> . � ' OTHER STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR TFIE <br /> - � PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> - APPL��ATjON IS MADE AND I COMPLV WITH THE STATE <br /> P�RCEt TAX I.D.NUMBER TF�ACTDRS LAW 1827 RCW AND 296200_ AC. <br /> . CONSTRUCT�ON LOAN IENDER.A�DRE55.TELEPHONE NUMBER /' /4� -� <br /> � SONR URE �ATE <br /> ' . CITY BUSINE55 LICENSE N0. <br /> � <br /> � PLUMBIN6 MECHANICAL <br /> � � NO. TYPE OF FlXTURE OR�TEM FEE NO. THPE OF ECUIPM:CNT FEE <br /> . �, WATERCLOSET�TOILET) � A/C—A/HNDLGUNITS—H.P. ' <br /> . BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.R. ' <br /> � <br /> ' LAVATORY(WASH BASIN) � HEAT PUMP � , <br /> �� SHOWER � UNITHEATERS—B.T.U. M ' _ <br /> KITCHEN SINK 6 DISP � CLOTHES DRYERS �_ <br /> � � VENTILATIONFAN Se.e�� C:GJ.��� ' <br /> DISHWASHER <br /> LAUNDRYTRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER ' <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FiREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIPEPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GASFIREPLACE � . ' <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE ' <br /> ' GAS PIPING � <br /> i EXHAUST FAN � <br /> � ' <br /> i ' <br /> i ' <br /> � ' <br /> � <br /> SUB TOTAL $ � SUB TOTAL $ , <br /> PERMIT $ � PERMIT $ �f� <br /> TOTAL FEE $ ' TOTAL FEE $ �7 —� <br /> POR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SFTBACN SIOE SETBALN PUN�NECN NUMBF.e FEF NECEIPT NO. <br /> usezor+e LOTRREA VRC�NTSITE FEES VAWATION FEE <br /> IIYES fl NO i <br /> euuniNc , <br /> HEIGHTLIMITATION NO.OFOWELLING SIZEOFBLOGR.1 <br /> UNIi$ PLUMBMG <br /> T <br /> i <br /> OCGUP�NCV NOO�S�OFIES OCCUPANTLOAD B�SE61ENi MEC11nNICaI <br /> GROUV � <br /> fIVES �I NO � <br /> FIREAIBRMREOP �FA504 Pf]DIIIONnI.PIANCH[CK <br /> O1NEP <br /> FIRF.SPRINKLERREOD RF�SON <br /> STA1E OIIILORlG SUf1GH�RGE <br /> TYPEOFf,ONST PLANSAPCPOVE�BV CITYOFEVERETT runi.icwonKs i <br /> LOCAL SALES <br /> oarE TAX CODE IS 3105 TOTAL ' _ <br />