Laserfiche WebLink
APPLICATIC J FOR CONSTRUCT _ JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 •259-8810 <br />❑ DEMOLITION ❑ <br />BUILDING R3 MECHANICAL ❑ PLUMBING ❑ SIGN <br />Wcxl ,s bev +- Gr k 11 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAILADDRESS CITY ZIP PHONE STATE LICENSE <br />Aw.evtcn ,. G.ro. %?ill IS3^ v S4- <r mL, GIf; elf-) A-JU1v-21 SPrlir/A)C <br />PLUMBING CONTRACTOR MAILADORESS CITY ZIP PHONE STATE LICENSEM <br />T PRICE OF walK <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCNBE WORK AND SOUARE FOOTAGE RVOLVEO <br />T PERSON AND PHONE NO <br />t_ Lc�L (7b&) <br />FI PGC S <br />EREBY C_RTIFY THAT I 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 />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRIMING OF A PEPMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REC JLATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTIOM. 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 LAAWI �18.27 RCW AND 296.200 WAC. <br />• `^-- • 2 (e ' "7' <br />PROr�OlD USE <br />LIEIG&tiSOROPTIONOF PROPERTY ISH("BELOW ORATTACK TWO COPIES) <br />LDT BLOCK DF <br />PARCEL TAR I.D. NUMBER <br />CONSTRILICTON LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />SIONA DATE <br />CITY BOSRESSUCENSE NO <br />PLUIIIIIIMD <br />MECHANICAL <br />ND. <br />TYPE OF FIXTIME OR REM <br />FEE <br />NO. <br />TYPE OF EOIIIIIIII&IM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />MC — A/ OMW UNITS <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS <br />; <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />, <br />SHOWER <br />UNIT HEATERS <br />' <br />KITCHEN SRN( 8 DISP <br />; <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />' <br />_ <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />; <br />CLOTHES WASHER <br />, <br />WOOD STOVE <br />, <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />_ <br />DRNI(NXi FOUNTAIN <br />, <br />FIREPLACE INSERT (WOOD BURNING) <br />i <br />_ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />' <br />SACKFLOW PREVENTERS <br />GAS RANGE <br />; <br />SINK (SERVICE — BAR. ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL f <br />' <br />SUB TOTAL f <br />; <br />PERMIT f <br />, <br />PERMIT f <br />TOTAL FEE S <br />' <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />FAINT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PIANCIECKNIIBER <br />FEF <br />RECEIPT NO <br />152& <br />, ?D <br />119E ZONE <br />LOT AREA <br />VACANT SITE <br />EES <br />VALUATION <br />FEE <br />T <br />� <br />DYES O NO <br />BUIORf• <br />HEIGHT LIMITATION <br />NO OF ONELUNG <br />SIZE OF BLDOIT I <br />LAATS <br />PLUMBING <br />} <br />OCCUPANCY <br />0 <br />NO IN SIGNS <br />OCCUPANT LOAD <br />BASEMENT <br />MNECNAIRUI <br />) <br />DYES ❑ NO <br />ADDIIONALNANCIIFCK <br />FIRE SPR'KLER REOD <br />RFASON <br />OTHER� <br />I <br />i <br />— <br />FIRE ALARM gEO'p <br />REASON <br />— <br />STATE BUILDING SURCIIARGE <br />TYPE OF C.ONST <br />PLANS QPP VEn eY <br />CRY OF EVERETT <br />Puel K INoms <br />lA� <br />LOCAL SALES <br />TOTAL <br />--- <br />—'— <br />7 2 j <br />TAX CODE IS 3105 <br />f DATE <br />