Laserfiche WebLink
-4- S51-771 <br />APPLICATICA FOR CONSTRUCT.JN <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />❑ DEMOLITION ❑ COMBINATION BUILDING ❑ MECHANICAL <br />PROJECT ADDRESS: 3 ► 20 `.-e <br />_i _ .t s-/ � .7 _ <br />OWNER r ZIPPHONE ' _. ' <br />]^Cnl <br />ARLIUTECTORDESIGNER MAN ADDIIE55 CITY ZIP PHONE <br />PERMIT <br />�* <br />jd PLUMBING ❑ SIGN <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIr PHHONE <br />STATE LICENSE I <br />MECHANICAL CONTRACTOR <br />MWLADORESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE I <br />PLUMBING CONTRACTOR <br />_ , I L <br />MAILADDRESS <br />I i L �^ a <br />CITY <br />ZIP PHONE <br />_.I , .9._ al IP.nai_ <br />62. STATE LICENSE I <br />(07Z-110 <br />9 -A JTL.w,�r5tll.Pl <br />CONTRACTrACEa <br />HEATING SYSTEM: 7H GAS ❑ ELECTRIC ❑ <br />DESCRIBE WOIM AND SQUARE FOOTAGE �D <br />CONTACT PERSON AND PHONE NO <br />I HEREBY CERTIFY THAT 1 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 />BUILDING <br />PROPOSED USE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />DESCRIPTION aPROPERINMHOWNBELOW ORArtACHTWO COPIES) <br />LEGAL <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISKIN OF ANY <br />LOT BLOCKa <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT ON OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORG FD 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 295.200 WAC. <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPLIPNE NUMBER <br />DATE <br />CITY BUSINESS LICENSE NO <br />MECHANICAL <br />RING <br />NO, <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOMP VA NT <br />FEE <br />' <br />WATER CLOSET (TOILET) <br />A/C—AMNOLG UNITS <br />FORCED AIR SYSTEMS <br />i <br />BATHTUB' <br />HEAT PUMP <br />LAVATORY (WASH BASIN) <br />1 <br />SHOWER <br />1 <br />UNIT HEATERS <br />' <br />KITCHEN SINK 8 DISP <br />' <br />' <br />CLOTHES DRYERS <br />' <br />—�— <br />' <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />WASHER <br />WOOD STOVE <br />' <br />' <br />1 <br />METAL FIREPLACE (WOOD BURNING) <br />7-URI <br />URINAL <br />FIREPLACE INSERT (WOOD BURNING) <br />1 <br />DRINKMK3 FOUNTAIN <br />FLOOR DRAIN <br />GAS FIREPLACE <br />' <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />are S <br />1 <br />EXHAUST FAN <br />' <br />I <br />' <br />' <br />T <br />' <br />SUB TOTAL f <br />, <br />SUB TOTAL S <br />PERMIT S <br />PERMIT S <br />TOTAL FEE f <br />' <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REM SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />// <br />FEF <br />RECEPr No <br />FEES <br />VALUATION <br />FEE <br />USE ZONE <br />LOT AREA <br />VACMISITE <br />DYES ❑ NO <br />BUILDING <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGITH <br />3 <br />LINTS <br />PLUMBING <br />MECHANICAL <br />I <br />' <br />OCCUPANCY <br />NO IF SIDRES <br />OCCUPANT LOAD <br />BASEMENT <br />' <br />GROUP <br />OYES O NO <br />ADDITIONAL PLAN CHECK <br />- <br />FIRE SPRINKLER REO'D <br />REASON <br />- I <br />I <br />OTHER <br />I <br />FIRE ALARM REO'D <br />REASON <br />STATE BUILDING SIIRF.HAHi6E <br />ruellr.woRKS <br />TYPE OFCONST <br />aANSAPPRovFOBY <br />CITY OFEVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />1 TOTAL <br />DATE <br />