Laserfiche WebLink
, �iPPLICATII.N FOR CONSTRUC: .ON PE�MIT <br /> GITY OF EVE�ETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> I <br /> ❑ DEMOLITION ❑ COMBINATION CI BUILDING ❑ MECHANICAL f� PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> �7�� io � /�i v,J �a� l3 <br /> rnni�nnoness �irv Zu <br /> rnone <br /> Select Homes 12P,12 Sth Ave W ;iA-201 Everett WA 98204 513-9006 <br /> TEN�NT IAA.I_ApURf.55 CIIY <br /> Z��' PIIONF. <br /> hRC11RECTOPDLSIGNER MAILA��qE55 ��ry <br />� ZIP PHONE <br /> GENER�LCONTRnCiOR MAILAUOqE55 ��t� ' Z�� <br /> PIIONE STATE LICENSE M <br />� MECHANICALCONTRACiOR MNLADDRE55 CIN Zlp <br /> Pt10N[ STATE LICENSE M <br /> Anchox P1umLinQ PO Box 1478 Marvsville 98270 286-7889 ANCHORPH141LN <br /> PLUMBINGWNTqACTOR MAILA�DRE55 CI7Y <br /> ZIP PIIONE STATE LICENSE� ' <br /> CONTRACT PRICE OF WOI1K <br /> HEATING SYSTEM: Ll GAS ❑ ELECTRIC Ci <br />� OESC(iIDE WORK AY�SOUARE FOOTAGE INVOLVED CONTACT f�ERSON AND PHpNE N0. <br /> Sprinkler 7�j l � <br /> I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> PROPOSED USF OF BUILDINC APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORRECT.AlL <br />� SFR PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL�ESCRIPiiONOFPqOPEFl7Y(SHOYfNBELOWORAT7pCHTWOLOPIES) WaRK WILL BE COAIPLIED WITH WHETHER SPECIFIED HFREIN OR <br /> NOi. THE GRANTING OF A PEHMIT DOES NOT PRESUME TO GIVE <br /> �oi BLOCK oF AL'THORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> O7HER STATE OR LUCA�LAW REGULATING CONSTRUCTION OR THE <br /> — P�RFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZGD BY THE <br /> GWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> l�PPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAACELTA%I.O.NUMBER �ONTRACTORS LAW ifl27 RCW AND 2g6.200 WAC. <br />( <br /> CONSTRUCTION LO�N L'.N�ER AOOf1E55,iELEPMONE NUMFlER __(. / <br /> SIGNnTURE /� /` f� <br /> �ATE <br /> CITY OUSWE55 LICENSE N0. <br /> PLUMBING --- <br />' MECHANICAL <br /> NO. TYPE OF FIXTIIRE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSE7(TOILET) —T— <br /> ' A/C—A/HNOLGUNITS—H.P. , <br /> BATH7UB _ ;_ FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � <br /> LAVATORY(WASH BASIN) � <br /> � HEAT PUMP <br /> I SHOWEH � UNITHEATERS—B.2U. M � <br /> i KITCHEN SINK 8 DISP ; CLOTHES DRYEP.S � <br />�, DISHWASHEA � VEN'fILATION F.qN — <br />� LAUNDRYTRAY � ' <br /> � RANGE HOOD � <br /> I CLOTHES WASHE.9 � WATER HE?.TER <br /> URINAL � WOOD STOVE , <br /> DRINKINu FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) ' <br />� FLOOR DRAIN ' <br /> ' FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE � <br /> 31NK(SERVICE—BAR, ETC.) � GAS RANGE - <br /> -- � <br /> ; GAS PIPING - <br /> — � <br /> � EXHAUSTFAN � � <br /> —,— , <br /> � <br /> � <br /> ' <br /> _ � � <br /> T i <br /> SUB TOTAL S SUB TOTAL S ' <br />� PERMIT S I PERMIT S � <br /> TOTAIFEE S � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBhCK REMSETO�CN SIf)ESETOACK PLANCII[CNIII OER F[E c�7 RECEIPTNO. <br /> ��;� �,i�� i <br /> usezoNe �ornnEn vncnr;rsire FEES VAWATION FEE <br /> n res ❑ No —r— <br /> i — nw�oiwc � <br />� HEIGNT LIMITATION N0.OF OWELLING SIZE OF BLOGR.I. � <br /> uwis <br /> PLUMpING � <br /> OCCl1PANCY NO OF STOIiIES OGCUPpNT LOn� — <br /> GROUP OASEMEN� �/,ECMnNICAL � <br /> fl YES Il NO � <br /> I FIPEALARMREO'D REASON AD�ITIONAIPI.ANCIIECK � }� <br /> -y'� iC'V <br /> T— <br /> FIRE SPRINKLER RE�'D PE�SON OTNEF � C � — ` G i `� <br /> STATEBUILDIN SURCNARGE I � <br /> i <br /> TYPE OF CONST P�qt�S PROVED OY -- �----� <br /> CITY OF EVEFlETT PUBLIC WORKS � <br /> � � LOCALSALES — � <br /> O�TE �-' /�_ <br /> � ��� TAX CODE IS 3105 � TOTAL ;' <br /> .. C�-� i ��� <br /> _ � <br />