Laserfiche WebLink
I <br />9 '"3 <br />pzx <br />c H <br />syxti <br />y Z3 <br />.0 n <br />H 0 <br />CA I -`I <br />14 <br />OHS <br />ZOE <br />MHz <br />HH <br />H <br />ty N <br />CG+] r <br />b7 <br />Z <br />FAW <br />Hti 0 rA <br />APPLICATIk,A FOR CONSTRUCI.ON PERMIT <br />L',e fell <br />me n F9•Pr e <br />CH Y GF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK —PLEASE PRINT <br />259-8810 <br />I DEMOLITION I I COMBINATION i BUILDING MECHANICAL I PLUMBING SIGN <br />PLUMBING coNTRAclon MAIL ADBnrss <br />LRY 211' PIKRIE LICENSE A <br />CLASS OF WonK nneTnvc 60Dl MCPRT 67i RUILDING RELOCATION <br />I I NEW I I ADDITION I I ALH:HAIIUN I I n«....-,•�--••— <br />--- <br />TENANTIlAPROVCMENIORIN4�T((ERIORREMODELLaILY <br />CONTACT <br />PERSOJLAND PHONE No / [�_ •`� <br />Gl <br />— <br />L'S Z <br />L O <br />CONTRACT PRICE OF WORK.0 / <br />DESCRIBE WonK AND SQUARE FOOTAGE INVIXVEO 7F2e�o�L•TJL. <br />,� II'p <br />r,(_Co4»15jk <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED USE OF OUR DING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />S�ISqC� <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL Descmm�oN OF rnorER IIOWN B[IOW OII AilA1:H FOUfl COPIES) <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BI OCK OF <br />TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />AUTHORITY <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 18.27 RCW AND 296.200 WAC. <br />. - <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGEN T DATE <br />X <br />-- <br />\ <br />i7y2q? <br />9,2Z _y,-,, Iret°— q <br />PROJECT ADDRESS <br />— <br />APPI'" `NT$ CITY BUSINESS LICENSE 1!O AND BUSINESS NAME <br />;3W Motes <br />•• <br />NO. <br />_AICAL <br />TYPE OF EQUIPMENT <br />FEE <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />I <br />;VC—A/HNDLG UNITS—H.P. <br />WATER CLOSET (TOILET) <br />' <br />FORCED AIR SYSTEMS—B T.U. M E.A. <br />BATHTUB <br />UNIT HEATERS—B.T.U. A <br />LAVATORY (WASH BASIN) <br />I <br />Cl OTI IES DRYERS <br />SHOWER <br />i <br />VENTILATION FAN <br />KITCHEN SINK 8 DISP <br />----' <br />RANGE HOOD <br />DISHWASHER <br />WATER HEATER <br />LAUNDRY TRAY <br />I <br />WOOD STOVE <br />CLOTHES WASHER <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />i <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GAS PIPING <br />�— <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />1 <br />EXHAUST FAN <br />' <br />SUBTOTAL $ <br />SUBTOTAL <br />$ <br />PERMIT $ <br />PERMIT <br />$ <br />TOTAL FEE $ �— <br />-- TOTAL FEE <br />$ <br />SIDE SETBACK <br />PIANCRICK IIIIMBER FEE RECEIPT NO <br />FRONT SST➢AGN ROAR SETBACK <br />USE ZONE TOT AREA <br />VACANT SIZE <br />FEES VALUATION FEE <br />❑ YES 17 NO <br />BUILDING <br />IYPEOfCONSTAlIGIVABIE <br />TYPE Of CMIR ACTUAL <br />pLNFLBCT <br />ABgp <br />W n MUMM"S <br />PLUMBING <br />I <br />i <br />SIZE OF BLDG. <br />NO OF STORIES <br />EASEMENT <br />MECHANICAL <br />I I YES I I NO <br />i <br />OTHER <br />OCCUPANCY TOAD FIRE 6Pfl1IKLER5 nC0D <br />IIEIGIIT LIMITATION <br />i <br />LI YES I NO <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />' <br />REASON FOR SPRINKLEnS <br />MANSAPPROV DBY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />APPLICATION ACC. BY <br />LOCAL SALES <br />o�jj, <br />TAX CODE IS 3105 <br />TOTAL <br />