Laserfiche WebLink
r---. . . —.. . . : _, <br /> I �� APPLICATION FOR CONSTRUCTION PERMIT '. <br /> t <br /> everett <br /> ��E����� e <br /> CI7 Y OF <br /> everett <br /> FiUILDING DEPARTMENT TO BE COMPLETED IN INK—PL SE PRINT . <br /> 253-8810 <br /> ❑ DEMOLITION I 1 COMBINATION I I BUILDING , ECHANICAL I I PLUMBING I I SIGN <br /> MAILADDRESS � Cm il�w P�E � � , <br /> EN � y ,y <br /> C i, <br /> TENANi MA�LAUDPESS CITV ZIP PNONE �1���, <br /> I��� <br /> ARLHITELTORUESIGNEfl 1AAILADORE55 <br /> CITV 21P PNONE I•:'. <br /> {�:i <br />�G ER� TPACTO MAIL E55 IN ZIP PHONE �E/ 1��:. <br /> O � 1 <br /> O\ � 1.' <br /> CIfV ZIP � �PHONE _ q `IICENS�I �� � I'� <br /> CMANILALGON R MAIL PESS /VLP / <br /> L � u c7 [.. <br /> RUMBINQ CONTR�CTOfl M�IL A[IDRESS CIN Z�P PHONE LICENSE� <br /> i; <br /> CU55 OF N4MiN � <br /> ❑ NEW ❑ AODITION .i ALTEflATION ❑ REPAIR I.I DEMOLIiION f 1 WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION �.� <br /> TENANT IIA7ROVEMENT OR INTE R E ODE}��( LONTACT PERSON AN�PNONE N0. ,;,'` <br /> CpNTR�CTPRIGEOFM'ONK: UU �� ' <br /> ;Y <br /> DESLRIBE WORK AND SOUARE FO�TAGE INVOLVED �r�� <br /> i.j;. <br /> vn ED eoFeu ort+a � ��Q—e-� 1 HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS ��,�'� <br /> � �,. (�i����� APPLICATION AND KNOW THE SAME TU BE TRUE AND CORRECL ALL u:,,. <br /> LEOALDESCRIPTIONOFPROPEH7Y�WOWNBELOWORATTACHFWHCAP�ES) PROVISIONSOPLAWSANDORDINANCESGOVERNINGTHISTYPEOF f; � <br /> WORK WILL BE COMPLETED WITH WHcTHER SPECIFIED HEREIN OR ��,�� <br /> inr eiocK nF N07. TIIC Gf1ANTING OF A PCRIAIT DO[S NOT PRESUIdG TO GIVL ' <br /> — AUTHORITY TO VIOLATE OH CANCEL lNE PHOVISIONS OF ANY 4��'.; <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE r,:�; <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE .,�: <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH �'•�' <br /> V�i <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.2%RCW AND 296.200 WAC. '<p� <br /> SIGNATUREOFGONTR�CTOROflAUTHORI2ED�GENT DATE �d <br /> �.✓�,� <br /> X � E � <br /> r... <br /> � <br /> PRQIECTAODRESS� ���,�,� <br /> AP I RNTSGINOUSMES ICENSENO.ANDBUSINESSN�ME <br /> � :i,: <br /> PLUMBING MECHANIC�L ��%� <br /> i;y�;; <br /> Np, TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE „7i <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' 9��� <br /> , UNIT HEATERS—B.LU. M i �'�� <br /> LAVA"(ORY(WASH BASiN) ^'��� <br /> � CLOTHES DRVERS ' ��f <br /> SHOWER , i`!. <br /> KITCHEN SINK 3 DISP I VENTIIATION FAN ; f:;:, <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY ; WATER HEATER � !i'� <br /> � WOOD STOVE � � <br /> CLOTHES WASHER � `�' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY : l�.�. <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � a.- <br /> � i::;. <br /> FLOOR DRAIN � NEA!PUMP . <br /> , <br /> BACKFLOW PREVENTERS i GAS PIPING � �G' <br /> � HAUST F N ' i1�� <br /> ROOF DRAINS—RAINLEADERS I!'!� <br /> SINK(SERVICE—BAR,ETC.) ; � L ' �;•:. <br /> � �_«. <br /> � � 1�.. <br /> 1 �4�.� <br /> � , ��1. <br /> 1 1 �.'l. <br /> F��, <br /> �':� <br /> � SUB TOTAL $ '� `4�� <br /> SUBTOTAL $ � pERMIT E � t��'�' <br /> PERMIT $ � � ^�� <br /> TOTAL FEE $ ' TOTAL FEE $ ' t..,-:, <br /> pEGEIPTNO. �" � <br /> FRONT SETBACK REAR SETBRCN SIDE SEiBACK PUN CHECH NUMBEH FEE r�, <br /> x^4 <br /> VAWATION FEE ��'i' <br /> USE20NE LOTAflEA VACANTSITE FEES �!i., <br /> ❑ YES ❑ NO � ��'� <br /> BUILDING ' �, <br /> ttPE OF CONST ALIOWABLE ttPE OF CONST.�C1UAL �>�+ NO m owtuwG uxrt6 � j R': <br /> GRWP � <br /> � PLUMBINO� � <br /> � � �; <br /> SIZEOFBLDG. NO.OFSTONIES BASEMENT MECHANICAL � ��, <br /> ❑ YES ❑ NO ' "' <br /> OTHER � � <br /> OGGUPANCYLORD FIflESPRNKLERSREO'U MEIGHTLIMITATION � <br /> Y <br /> ❑ YES ❑ NO ' '�`;�� <br /> STATE BUILDING SURCHARGE � 4��j�. <br /> REASONFORSPRINKLEf75 � �}?': <br /> STATEENERGYSURCHARGE � <br /> i i�; <br /> �PPIICATION�CG.BY PUNSAPPROYEDBY CITY OF EVERETT PUBUC WORKS i P.� I <br /> LOCAISALES ' <br /> TAX COUEIS 3105 T�TA� ' � <br /> �r, <br />