Laserfiche WebLink
CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-881U <br />❑ OEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />PROJECTADDRESS:oi.��3- � .Sr .Ll�ere�. k/d_ 9ss2al <br />MNLADDRESS <br />M�II AODRE55 <br />GtV <br />zm <br />nr <br />❑ PLUMBING <br />— / <br />5 Z_ " -- <br />G�NERALCONIMGTOR MAILApORE55 CIIY 711` P�IOHF SIAILLICENSE• <br />AIECIIANICAI CONTRACTOR MAIUDDRE55 GP! ZIP P�IONE $T�TE LILENSE � <br />PlUM81NGCONTR�CTOR MAILADURE55 CIfY ZIP P��ONE STATELICENSE• <br />CONTR�CT PRICE OF WORK � <br />�` I �QO HEATING SYSTEM: ❑ GAS �ELECTRIC ❑ <br />UESLRIBE WORK �ND SOUAAE FOOTAGE INVOLVED _ / � CONTFCT P[i150N AN� PHONF NO <br />.�ia,�'lti . <br />ni ucu iwa cories� <br />LOT _.,/�_ BLOCK <br />�ty ii-u�'U7'y U� <br />CONSTfiUCT10N LO/�N LEN�ER, AOORESS. TELEPHONE NUMOEfl <br />NO. TYPE OF FU(TI <br />WATER CLOSET (TOILI <br />BATHTUB <br />LAVATORY (WASH BAS <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT <br />CINK lSFRVICF — RAi <br />p <br />�TEM <br />SUB TOTAL E <br />PERMIT 5 <br />TOTALFEE S <br />FOR OFFiCE USE ONLY: <br />FRONTSETAACK ��$T. REAR SETBALN <br />�a 20 <br />USE ZONE LOT AREA <br />�— � Ocx <br />IIEIGIIT lllAIUTION NO OF DWELLING <br />L� ' UNIiS I <br />OCCIIP\NLY NO Of SIOnIEE OCCUPRNi LOAO <br />FIf1E <br />tvrF <br />RFASON <br />aEnSON <br />FEE <br />0 <br />� <br />❑ SIGN <br />I HEREBY CERTIFY THAT I HAVE READ AND ExAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER &PECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME TO G�VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHEfi STATE OR LOCAL LAW REGULATING CONSTRUCTION OFi THE <br />PERFORMANGE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OWNER OF THIS FROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW ANU 296.200 WAC. <br />CITY BUSME55 LICGNSE NO <br />MECHANICAL <br />NO. TYPE OF EQU <br />A/C—MiNDLG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATEH <br />WOOD Sl'OVE <br />METAL FIREPLACE (WO( <br />FIREPLACE INSER? (WO <br />GAS FIREPLACE <br />GAS PANGE <br />GAS PIPING <br />EXHAUSTFAN <br />SIDESEIO�CN Vl{1ihK AJ� �lANC11CCNNUMOf(i <br />s d ,o � .�"397� <br />WCANI SIIf. FEES _ <br />❑res ' rvu nunnir,c <br />size or o�.ixni �-- <br />3 � �-- P111M01N1--_'— <br />BASFMENI MECIIRNIf.AI. <br />❑T[5 L ��0 — <br />---- 40�IIIONALPLANC�IfCN <br />ou�en <br />SIAIE OURORIG SURC���nGE <br />CITY OF EVEFlETT runnr. wonns <br />LOCAL SALES -- --� <br />� TAX CODE IS 3105 TOTAL <br />SUB TUTAL 5 <br />PERMIT $ <br />TOTAL FEE S <br />OS nrceirr r+o <br />✓ALUATION FEE <br />3363 _� <br />2 <br />0 <br />