Laserfiche WebLink
APPLICATIOw FOR CONSTRUCTI%jN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8010 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBINU ❑ SIGN <br /> PROJECT ADDRESS: ;?.1 7- - <br /> 0fn A MAIL ADORE SS CIM1 lip PHONE <br /> Q( �!//rlff/7P�o�v 157ficfi--2 �i��A✓ I 2r-3C.� <br /> TENANT MAIL ADDRESS CITY 11P PRONE <br /> AIICIIIT[CT IXI DES GMCR ( <br /> Wil ADDRESS CITY /IP P1ONF <br /> hl ;ErA/L[/ys /lsnA1C1 �amr N s 9l�Gv+ _ /17c1 t e e t �.rq; <br /> GENERAL CONIRA(IOR MAA ADDRESS lilt ➢r PRONE 51AIC 1ICENSEf <br /> MECHANICAL CDNIRACIOR MML ADDRESS CITY !IP PRONE STATE LICENSE[ <br /> PLUOB MIRNGCGNIRACIMAILADDRESS UfY lip P1ONE SIAIC)ICF NSU <br /> C(SNIRACT PRICE(V WORK HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> DESCBE YORK AND SQUARE FOOTAGE INVOLVED f.ON1Af '[RSOn AND P110NE NO <br /> RI <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> - APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PET01'OSE D USE OF ITUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIOl,OF PROPERTY ISIIOYVN BELOVVC 1�1TA(:HTWO)COPIES) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ON OF ANY <br /> LOT�—ELOCK DF �r-f--� — OTHER STATE OR LAUTHORITY TO IOCAL LAW REGULATING CONSTROLATE OR CANCEL THE UCTION 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 (.OMPLY WITH THE STATE <br /> CONTRACTORS LAW 10 27 RCW AND 296.200 WAC. <br /> AEEL TM 1 D MIIAflER <br /> CONST RUCTION LOM)LENDEII ADDRESS.TELEPHONE NUMBED <br /> SIGNATURE DATE <br /> City BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> _ NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATEF:CLOSET(TOILET) A/C—AMNOLG UNITS - —�— <br /> BATHTUB ; / FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT Pl1MP <br /> SHOWER ' UNIT HEATERS <br /> KITCHEN SINK A DISP CLOTHES DRYERS ' <br /> DISHWASHER / RANGE HOOD <br /> LAUNDRY TRAY ' j WATER IIEATER <br /> CLOTI-ES WASHER I WOOD STOVE <br /> URINA.. METAL FIREPLACE(WOOD BURNING) <br /> _ DRIN_K.NG FOUNTAIN i FIREPLACE INSERT(WOOD BURNING) <br /> FLOI)I1 DETAIN / GAS FIREPLACE _ <br /> BACKFLOW PREVENTERS GAS RANGE <br /> NN 1!.ERVICE—BAR, ETC.) 1 L GAS PIPING <br /> SI _�- <br /> - f EXHAUST FAN <br /> I <br /> 1 <br /> 1 <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT $ 1 PERMIT S <br /> TOTAL FEE $ ' TOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> nrcnrl No <br /> IRONT SriPA.l,K / REAR SETBACK SIDE SEIflACN�/ — PI AN CIIEf.K NIIMD[O rFF <br /> USE LONE I 101 AREA VACANT SIZE <br /> FEES VALUATION F.°E <br /> --.— CI YES ❑ NO <br /> RE1GRT LIMITATION I 110 OE AVIALING <br /> owls <br /> Sill -17 2 % <br /> Ib11 pL-IA24 I low,"G <br /> OCCUPANCY NO 015111A11S OCCUPANTLOAO BASEMEN' MECHANICAL �I <br /> GROII_P — <br /> FK1�'// Il ❑YE5 NO <br /> L ADfN I IONAI Pt AN CHE CK 30 j 00 <br /> I IRE SPRINKLED REG i I DF ASON — <br /> 1 <br /> Rurtn I <br /> HnEAUUIM REG 6— Elf ASDN <br /> 5T61i BIIADING 5111tHAnnE <br /> TYPE of tomsr PIANSAPPRUVE`j B CITY OF EVERETT PHnnr.wDnKS G[/i•�_�_-"`- <br /> 1 I 1 LOCAL SALES - - <br /> � u•IE !O ) /5(v TAX CODE IS 3105 TOTAL 90 <br />