Laserfiche WebLink
APPLICATIOd FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT. WA 98201 • 259-8810 <br />DEMOLITION COMBINATION BUILDING IMECHANICAL PIIJURINr clr_u <br />3ROJECT ADDRESS <br />NAIL ADDRESS Cm ZIP PHONE <br />TFNAIJT ./nll AD[RF55 CRY IIP PHONE <br />ARGHRf.CT OA DESIGNER MAII MORE55 CITY 71P PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br />ti J i. L Al 1 _ _ <br />���..-...,... w....�,�� <br />K•R AoLn¢» <br />CITY <br />ZIP - - <br />PHOML <br />STATE LICENSE• <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE A <br />CONTRACT PRICE OF WORK <br />-- <br />HEATING SYSTEM: I 'I GAS 11 ELECTRIC I l <br />DESCRIBE WORK AND SWMI F AGE INVOLVED <br />�� C <br />SPNTACT PERSON AND PHONE NO <br />. Jc� <br />I HEREBY CERTIFY 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 GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <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 />APPLICA14 IS MADE AND I COMPLY WITH THE STATE <br />CONT OR 7 RCW AND 296.200 WAC. <br />X _ .7 51 <br />!/DATE <br />PRoPosmvSE OF BUILDING <br />' n <br />' �+'4 <br />LEGAL 5ca1 ION OFAROPERTY DSHOWN BELOW OR ATTACH TWO COPIES) <br />107 BLOCK OF <br />PARCEL TAXI D. NUMBER <br />CONSTRUCTION LOAN I ENDER. ADDRESS. TELEPHONE NUMBER <br />SIGNATUP- <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A7C—A7HNDLG UNITS—H.P. <br />�— <br />BATHTUB _ <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />1 <br />SHOWER <br />' <br />UNIT HEATERS—B.T.U. M <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />r <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />�— <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />' <br />SINK (SERVICE — BAR. ETC.) <br />GAS RANGE <br />�— <br />GAS PPINL"R <br />EXHAUST FAN <br />I <br />; <br />_ <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />' <br />PERMIT $ <br />1 <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />MONT SFTBACK <br />REAR SFTRACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FFF <br />aFCf PT NO <br />USEZONE <br />IOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />I1 VES IT NO <br />BUILDING <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />512E OF BLDGRI <br />PLUMBING <br />I <br />UNITS <br />OCCUPANCY <br />NO DT STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />GROUP <br />I <br />MECHANICAL <br />rIYE5 I NO <br />ADDITIONAI. PLAN CHECK <br />I <br />FIRE ALARM REO'D <br />REASON <br />OTHER <br />FIRE SPRINKIER REO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />PURIIC WORKS <br />— <br />TYPE OF CONST <br />PLANS APPROVED BY CITY OF EVERETT <br />LOCAL SALES <br />�— <br />1OTAL <br />I <br />DATE TAX CODE IS 2105 <br />