Laserfiche WebLink
APPLICATIOrV FOR CONSTRUC7.ON PERNAIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-A810 <br />rl DERAOLITION �l COMBINATION �BUILDING ,y�MECHANICAL r�pLUMBING fl SIGN <br />PROJECTADORESS �o9a� /%�D/ � <br />o�vNen MNlA0DRF55 cm nr m{or+e <br />.��"' 7 �i �� �t w ,..��-.-.-z � sz � s ;� - i 3�� �, <br />�i , n r i _ � � � � k >�� <br />Tc_Nnrvt unanoonFss aTv zia w�r,ne <br />ARCHITFCTOR�ESIGNEP MPIIp00RE55 CItV ]IP PHONF <br />GeNEf1ALCONiMCTOli MNI� f1E55 CI1V 11P PIION[ StATELiCENSE• <br />� Q r�. �c,�-�-� Qp l.� N 5'c o SS K� <br />MECHFNIC�ICOYTR�CT�(i MAq p�OFE55 f.ITV 21P P1109E STAiF IICENSi � <br />PWMcNGCONIRACTOR MNLADURESS CIiY ZIP PNONE STATELICENSE� <br />�ESCRIBE WORN ANU SOUARF FOOTAGE INVOLV80 <br />�JZ��..- 7 L.�—,,.�r <br />�Oi y �fi �.b <br />/�.c.ri ��% � <br />PROi'OSED USE OF BUII�ING � <br />:S.�r.r.�e ;t��rz�c, <br />LEGAL OES�C(PJIPTION OF PFOPERTY ;S WN BELOW OR ATTAC 0 C <br />LOT'�v _ BLOCK OF�� <br />1Jl�^vw�.� �.� <br />p�C� %.� <br />PARCEL TAX I.O. NUMBER <br />CONSTRUCPONLOANLEYOER.AD�PF.SS.IELEPHONENUMOFR <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY(WASH BAS!N) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNORYTRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. E7 <br />FEE <br />SUB TOTAL S <br />PEFMIT S � <br />TOTALFEE S , <br />FOR OFFICE USE ON�Y: <br />PRONTSF.TAACN qEAR SFT�ACK SIDESEiB�CN <br />USE20NE <br />� 3�'� <br />NEIGIRUMIiAT10N • <br />OCGIIPANCY NO 0� St <br />GROUP <br />��3 �•i i <br />FIfiE L�PM REO'D <br />FIRF. SPRINNIFR PEO [t <br />rvvE oF r,orisr <br />- - � �J <br />iora�En <br />NO Of DWfLLING <br />UNIt$ <br />OCCUPANTLOaD <br />VnCANi SITE <br />�iYES <br />]F ALU(i/II <br />3y Sr L� <br />R SF GA� <br />PASFldF.NT <br />f1VEi <br />f i NO <br />HEATING SYSTEM: Ka-GAS fl ELECTRIC f I <br />CONTA T P[RSON AND PNONF(: N�O. �� <br />�i� � n u. �!' . � L. J c. T\ <br />I HEREBY CERTIFY THAT I H�VE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PRUVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS TYPE OF <br />WC�FK WILL BE COM^LIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV£ <br />AUTHORITY TO VIOLAiE OH CANCEL THE PROVIS�7N OF ANY <br />CTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE ST�\TE <br />CONTRACTORS LAW 1��AND 296.200 WAC. <br />x s1 _-� � � p C� � <br />O J / � / <br />SIGNFIUF' OnTE <br />CITY f1U5ME55 LIGEtlSE NO <br />MECHANICAL <br />NO. TYPE OF F.QUIPMENT FEE <br />owinwc <br />rv�—rvnrvuw urvna—n.r. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PU!AP <br />UNITHEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER � <br />WOODSTOVE ; <br />METAL FIREPLACE (WOOD DURNING) i <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE ; <br />GAS RANGE <br />GAS PIPING ; <br />EXHAUSTFAN i <br />SUB TOTAL 5 <br />PERMIT S i <br />TOTAL FEE 5 . <br />rEe � necFirt uo <br />ACsE r ri.uu�niur, _��J � <br />� �dECN�NICRI �� <br />I.✓ryp —_—__ i " <br />— AODI11pN�1.PIAkG�[CK ; <br />OtHER <br />S10i@�UILDMGSUfiCIMqGE — c/ i� �'. <br />rin�isnrrnoveoov CITYOFEVERETT runnr,wonKs ^ � � <br />�J �' LOCALSALES — ----------- -- �--'-- <br />uATE �� TAX CODE IS 3105 TO7AL �(�,_l. �� � <br />—8�'-L -- � -- —� � � -- <br />0 <br />