Laserfiche WebLink
APPLIC�#1f10.1 FOR CONSTRUCT.JN PERlNIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 9�201 • 259•8810 <br />O UF�A��LITION ❑ COMBINATION I� BUILDING ❑ MECt1ANICAL ❑ PLUMBING f� SIGN <br />PROJr_CT ADDRESS . , i <br />�.. - '- <br />JY/UFd MMIADDf1Eg5 CrtY bP P��ONE m-- <br />.Inn.cs ♦ �F�y <br />f))Af _"..s..../ /�Sii`T'.ai7��!/ �-�. .�i// C. Ya�,1' '�bJ� z �/G '�.36/ <br />�_' <br />TENANT uM��pp11[SS crtv )�P f�lONc <br />�P':IIRECiORDEa�6NEH MAIL�D�RESS GITV IIP PNONE <br />GENf.RAICOHIF�LIOR NUUDORE55 �ITV )m PIIONE STREII�ENSE� <br />� <br />�`—1 iS>' � .=9 �AV�C �li!/ �r�vC 5'$�i��L :,'i6.��(ei �iCl -oss–Jcil <br />IAECN6NIL�LCONiRACTOR MAI��DDAESS L17� TiC PIIONE SiRE:JCFNSE� <br />PWMBINaCONiP�CiOR MAqADORE55 CIiV Zi� FIIONE SiAtEUCE�4E� <br />CONTt1�LT PR�CE OF WOnN �— <br />DESCRIBE WORK AND SOU�HE FOOT�OE INVOLVED <br />�SIIOY+N B[lOW OR �R�LN T WO GOPIE51 <br />wr �T oiocK <br />LONSTi1UCTON LO�N IEN�ER. �DDf1E55. TEIEPNpNE NVMOEfi <br />fevN-li�r �,eri�C /�0�3ov t2P �11nv�s <br />3��-s�-o7 <br />PLUMBINO <br />TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUO <br />SHOWER <br />KITCHEN SINK 8 UISP <br />CLOTHES WASHER <br />URINAL <br />DPINKINO FOUNTAIN <br />FIOOR DRAIN <br />BACKFLOW PREVEN' <br />cww racavirc — nn <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CK REAp SCiO�CN <br />i <br />C� ` `� � <br />USE20ME^ LOTRRE� <br />�L � � L� � <br />NEIOHTUMIfAT10N NO.OFOWElUNO <br />� � UNIT$ I <br />OCCU�'ANCY NO Oi S�ORiES OCCUPANT LO�� <br />GWUP <br />�', � � U 1 2 �`: <br />FIREAURMPEO'� RE�SON <br />FIPE SPRINNIER RF7D REASON <br />�J IonT¢ IJ/Tr,/i��' <br />FEE <br />SIOE SEIH�CM <br />__ r <br />VACANI SSE <br />,�5 ❑ NO <br />)F Bl[`GR I <br />yy S�° C I vii.i <br />7n sF vn�nc,� <br />BRSEMENi � � <br />❑YES iYNO <br />HEATING SYSTEM: �'GAS O ELECTRIC O <br />CONT�Cf PERSON �ND Pl10NE NO <br />I H[FlEBV CERTIFV THAT I HAVE READ AND E%AIdWEO TH�S <br />APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT, ALL <br />PPOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK INILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. 7HE OAAfaTINO OF A PERMIT DOES NOT PRESUME TO GNE <br />AUTHORITY TO VIOLATE OR CANCEL TNE PROVISION OF ANV <br />OTHEH STATE OF LOCAL LAW REGULATINO CONSTRUCTION OR THE <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED �Y THE <br />OWNER OF THIS PROPERTY TO PERFURM THE WORK FUR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STA1E <br />CONTRA-�AW 1827 RCW AND 296.200 WAC. <br />x �'] �%��`G!-�d t G�" 01-3- `»- <br />510 ♦ nE��� 04iC <br />v .? 4 G 6�/ <br />Cliv OUS�NESS L�CENSE NO <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C —MiNDLO UNITS — H.P. �— <br />FORCED AIR S`!SiEA1S — B.T.U. M E.A. ; <br />F!EAT PUMP i <br />UNIT NEATERS — B.T.U. M . <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />GAS FIREPIPCE ' <br />GAS R�1NC� — �--- <br />GAS FiPING F <br />EXHAUSTFAN <br />3 <br />�- ' , .31�� . ' � <br />iMIiER/ I FEE � J i- I PECEIaTNQ` — <br />%�./ ���/ �'�/�. <br />J I <br />OUILDiNO 7s /' - � , <br />PWA�OINO � <br />� I <br />MEGHANIUL - <br />j'i�' 1 ( � <br />�DDITIONA� PIAN CNECK % i ' � <br />OiNER � <br />St�TEONIDINOSMCNenfE � / i' <br />CITY OF EVERETT runur, vmnKs -y ,; <br />LOCAL SALES " , ' , <br />1'A% CODE IS 9105 TOTAL —_� �/,', �{�, <br />