Laserfiche WebLink
APPLICATIO.d FOR CONSTRUC7 .ON PERMIT <br /> CITY OF EVERETf•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259•8810 <br /> fl DEMOLITION fl COMBINATION f� BUILDING �l MECHANICAL �l PLUMBING �l SIGN <br /> PROJECT ADDRESS <br /> J��S �//UE �/ . ,� UL—/2L !7 ���I • <br /> p�ER MRILFDDRESS CITY ZIP PIIONE <br /> X ,f/s,eit,u�EsT ,coc�/ni�� i�c��. 9/0/ ,rJ��,Qv� �-ln�� ��l ��'/7/ <br /> MAII.ADORESS CITY P PIIONE <br /> :'olU�,�'D J'o,vivSorv /�A 2� No rEL ��jl-�3�57� <br /> A CNITF.CTOR�ESIGNER MPII.A��RE55 Cltt ]IP PMONF. <br /> GF.NI. L,1CONTMCiOfI � MAILAOUR[SS CI1V :.iP PHONL $/qiE1.ICENSF• <br /> __riL�LL�Y'�� �/(//��L <br /> MECN�NICAI�ONiR�CTOR MAIL�DDRF.55 CITV ZIP PHONE STATE LICEPSE� <br /> PWMBINGCOMRACTOR MAILADORESS CIIY ZIP PHONE STAIELICENSE� <br /> CO T CTPRICEOPWORN <br /> �7(� HEATING SYSTEM: f l GAS �l ELECTRIC (1 <br /> 5 RIBE WORK AND SOl1ARF FOOTAGE INVOIVEU CONTnCi P[RSON AND RIONE NO. <br /> - t vi�v � <br /> ��' �1 io r�ic� <br /> �f�' X� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S <br /> PPO{qSED USE OF BUILUING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRf. �� <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS'1 YPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGRLUESCRIPTIONOFPROPERTY�SHOIYNBELOWORATIACM7IVOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME TO GNE <br /> �oT e�ocK or AUTHORITY TO VIOLATE Ofl CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> . PERFORMANCE OF CONSTRUCTION.THAT I AM PVTHOfiIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAXI.D.NOMBER CONTRACTORS LAW 1827 RCW nAND 296.200 WAC. <br /> CONSTAUCTION IOAN LENDER.�DDRE55.TELEPMONE NUMBER �`�� ./�J/RA��-!� 7/I T/7lS <br /> .NATURE DALE <br /> GTY OlI5ME55 LICENS[N0. <br /> PLUAABING MECHANICAL <br /> NO. TYPE OF FlXTURE Ofl ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET TOILET � �— <br /> ( 1 A/C—MiNDLG UNITS—H.P. � <br /> BATHTUB ; FORCEDAIR!'iYSTEMS—B.LU. M E.A. ; � <br /> LAVATORY(WASH BASIN) � HEAT PUMP --;— <br /> SHOWER � UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> DISHWASHER � VENTILATION FAN � <br /> LAUN�RY TRAY ; RANGE HOOD � <br /> CLOTHES WASHER � WATER HEATER � <br /> URINAL � WOOD STOVE � <br /> DRINKING FOUNTAIN METAL FIREPLACE (WOOD BURNING) � <br /> FLOOR URAIN � FIREPLACE INSERT(WOOD BURNING) ; <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ' <br /> SINK(SERVICE—BAR, ETC.) � GAS RANGE � <br /> ' GAS PIPING ' <br /> � EXHAUST FAN � <br /> � � <br /> SUB TGTAL 3 ; SUB TOTAL 3 ' <br /> PERMIT 5 � PERMIT S T— <br /> TOTAL FEE $ � TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSFTPPCN R[nq5FT0�CK SIDESEjAACl �I�NCHE.KNUMOFR fF[ RECEIPTNO. <br /> �� � � � <br /> usezor+r �nEn d vncnrirsne FE S VALUATION FEE <br /> C—Z �Oo � d- �6 nres r +o aunnirvr. Z /.7`J—I <br /> HEIGMTLIMIiPT10� NOOfUW&LLING 512E0101UGRI � <br /> Z J IINIIS PLUMOING i <br /> T <br /> OCCUP�NCY NJ OISIORiCS OCCUPANTIORD PASEMENT �fp�qpNlCAI � <br /> cnour <br /> IIYFS !1 NO -- -- <br /> FIRE�LRRAIREOD RFA50Y AppI110NALPIANCNF.CK ��(f�� �'' <br /> ---'--t= <br /> Ot11ER <br /> FIRF.SPRINNIERREO'O pF�50Y — <br /> STn1E OIIIl01NG SUfiCHMGE i rj� <br /> 11.� <br /> rvPe or coNsr r�n� •rnoven nv CITY OF EVERETT rum�r.wnr.s <br /> LOCAL SALES --- — <br /> oniE 7- �p -'?� TAX CODE IS 3105 7o7AL <br />