Laserfiche WebLink
APPLICATIO�� F�OR CONSTRUCT�Jtd PEF�Mi'i <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR .�iTREET � EVERETT, WA 98201 • 259-6810 <br />f-1 DEMOLITION f'�COMBINATION �I BUILDING I l MECHANICAL f l PLUMBING 17 SIGN <br />PROJECT RDDRESS 7C� n� ��� � »_ f`�7-� `�2 <br />C'r. L <br />O EF M�ILA�ORE55 CITV ZIP PHONE <br />oei�rsb �� C9�� L y�h� 3��Z-/i Th Sr C-z-d��r��,� � S� /S� � <br />TENRNT MAILA�ORESS G!V llP PHONB <br />ARCIIITECTOR�ES�GNER MAILADDRE55 CIN ZIP PHONE <br />.. . . �.�..�........,�im �ei� ur YINrv[ JIAItLIChNSE[ <br />�c�ca ./��r,n��� ��ir�T'r_ �59� �'-u4Xr�r�S�,� k�L G.iX6f�✓.r��c `t���7 1695-4.v>) f;�,�e�/uxra✓ <br />MECHANICAICONTPACTOfi M�ILAODRE55 dTV 21P PHONE STATEUCENSEx <br />PL1161BINGCONTRACTOR MFILA��RESS CIN ZIP PIIONE SiATELICENSEM <br />> �5 �..0� <br />��C4 !a�`'G � C�7 � I r✓G <br />/�UU�L, I✓r5r� u.yc <br />LEGAL OESCPIPTION OF PROPEPTY (SNOWN <br />LOT BLOCK <br />PARCEL <br />GONSTRUCTIONLOAN <br />PLUMBING <br />NO. TYPE OF <br />/ WATER CLOSET <br />/ BATHTUB <br />SHOWER <br />KITCHEN SINK & DISf <br />DISNWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />GRINKING FOUNTAIN <br />FLOOR DRAIN <br />/'/.Qi,C iiG[vJ,/Z�rG <br />—'-1--t— <br />E�S� G�irs+iT�� Fr�G�7' <br />!�.<Itx- 4.>���Gi�°r%C <br />TELEPMONE NUTAaER <br />BACKFLOW PREVENTERS <br />SINK (SC9VICE — BAR. El <br />OR ITEM <br />FOR OFFICE USE ONLY: <br />FRONTSETOACK PEFR SE7BAGK <br />USE ZONE <br />IIEIGI{T LIMITATION <br />OCCUPANCY NO OF <br />GROUP <br />LOTAREA <br />HEATING SYSTEM: fl GAS 1-1 ELECTRIC f 1 <br />CONTACT PERSON AND PIIO�VE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED Tf115 <br />APPLICATION A�D KNOW THE SAME TO BE TRUE AMD CORRECT. ALL <br />PROVISIONS OF LaWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GR.4NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATINC 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 />APPI.ICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTO/AS/I�/V 18.27 RCW AND 296.20D WAC. <br />.. I � ��''i/I ��1i �Y��--'! � <br />CIiY BUSINESS LICENSE N0. <br />MECHANICAL <br />FEE N0. TYPE OF FIXTURE OR ITEM <br />T <br />� A/C—A/HNDIGUNITS—H.P. <br />; FORCED AIR SYSTEMS — B.T.U. M E.A. <br />—? HEAT PUMP <br />' UNIT HEATERS -- B.T.U. M <br />i CLOTHES DRYERS <br />SU� TOTAL S ; <br />PERMIT S i <br />TOTAL FEE S � <br />SIDE SETBACN <br />NO OF OWELLING <br />UNITS <br />DATE <br />Bv <br />VACANT SIiE <br />f7YE5 ❑ NO <br />°RE OF OLUGRI. <br />BASEMEN7 <br />❑YES f] NO <br />CITY OF EVERETT <br />L6CALSALES <br />TAX CODE IS 3105 <br />VHNTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE <br />FIREPLACE INSER"� <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />PLAN CHECN hUM�ER FEE <br />FEES <br />DUILDING <br />PLUTAOING <br />1dECN4NICAl <br />A�DITIONAL PLAN CHECN <br />OTHER <br />STATE PUILOINC SURC/IFfiGE <br />ruouc wonKs <br />TOTAL <br />BI <br />SUB TOTAL 5 <br />PERMIT $ <br />TO?AL FEE S <br />RECEIPT N0. <br />FEE <br />� <br />