Laserfiche WebLink
■ <br />APPLICATICA FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 1,259.8810 <br />I I DEMOLITION f I COMBINATION fl BUILDING Fl MECHANICAL PLUMBING I I SIGN <br />PROJECT ADDRESS _ / / 5, <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />57�Y/` ��ILFCW7/7 /766,G )k5Mo/Si ��"w4MI;Z (.,e fE/zGa ST&- fF <br />TENANT MAILARORE.SS CITY ZIP PHONE — <br />rw�/aJemu �Un I HAT;TUH MAILADDRESS CITY ZIP LjPHDNE73y STATE LICENSE <br />Mor7A/i.L. 1/ Z21,j ZAd / ;:'010 ?C AJ ode. A., .. rYJl1/4.r/.�,.:- —0 00 si •._err/Pi„e-r-A., <br />CONTACT PRICE OF Wd1M <br />i77ya,02, <br />HEATING SYSTEM: II -+'GAS Fl ELECTRIC 1 1 <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />,/jP,96es <br />C INTACT PERSON AND PHONE. NO <br />- - - /�- /2,6 <br />1 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 GOVERNING THIS TYPE OF <br />WORK WILL DE COMPLIED WITH WHETHER SPECIFIED HEREIN Oil <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER 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 STATE <br />CONTRACTORS LAW 0.27 RCW AND 296.200 WAC. <br />X✓/`� / �� •/� p f <br />9 ATVRE GATE <br />PROPOSED— USE �iDIiNG • <br />�f� <br />LEGAL OESCRIPi1rN OF PROPERTY (SIIOWII BELOW ON ATTACH COPES) <br />Lot �9_ BLOCK of 2 ' <br />!T LYu <br />n r <br />PARCEL TAX I D. NUMBER IF <br />(rM _uay-upuZ <br />Cr RON LOAN ENDER. AODRE59. TELEPHONE NUMBER (/[A -�; •3 A. (. <br />/�? �AF/A[ GfNi�� 9'•f�C <br />Z ?ifs rf..s(✓ Ift, 77 q/p <br />CITY BUFINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />= <br />WATER CLOSET (TOILET) k,,, -j / / <br />I <br />_TYPE <br />A/C—AAiNDLG UNITS —H.P. <br />' <br />BATHTUB // <br />' <br />) <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) i / <br />I <br />HEAT PUMP <br />, <br />SHOWER <br />T <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />' <br />I <br />KITCHEN SINK II DISP <br />i <br />'} <br />DISHWASHER <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />' <br />CLOTHES WASHER <br />I <br />I <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE —BAR. ETC.) <br />I <br />GAS RANGE <br />I <br />' <br />GAS PIPING <br />I <br />EXHAUSTFAN <br />I <br />I <br />1 <br />, <br />SUB TOTAL S <br />' <br />SUB TOTAL S <br />PERMIT S <br />I <br />PERMIT T <br />T <br />TOTAL FEE S <br />' <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SFTBA` REAR SETBACK SIDE SETBAC PLANCHECK MBER fE RECEIPT NO <br />USE ZONE <br />HEIGHT LIMITATION <br />2 <br />LOT <br />/NO OF DWELLING <br />UNITS <br />DATE <br />I IYES II NO <br />BUILDING <br />OF SL�DGGR I <br />NZ dF~GwRACi F; <br />PLUMBING <br />BASEMENT / <br />1I YES / <br />MECHANICAL <br />ADDITIONAL PAN CHECK <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 310 i <br />OTHER <br />STATE BUILDING SURCHARGE <br />runurWORKS <br />TOTAL <br />