Laserfiche WebLink
APPLICATIC'`I FOR CONSTRUCT"'1N �ERMIT � <br />TO BE CUMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING.`iYSTEM: iJGAS JELECTRIC J__ _ I <br />BUILDING DEPARTMENT — <br />259�6810 <br />D�MOLITION COMBINATION X BUILDING � MECHANICAL PLUMBING SIG� <br />'��� � IdAIL A�pRE55 Uii ZIP �'��O�.0 <br />:'lt' ..�'riG _ lw ��/h 7.z�.� P/. _ SF Fra.aiY .,�.a . !yz oJ 3�7 -6l,P,3 <br />1:N�NT _ IAA�lADD9E55 CI'Y Z�P PHOH[ <br />ARGHII[CTORDESIGN[H mnawuu�m5 — <br />�w.acr- /rq;/ L• lncan� �/ l'.�.E- k+A• 33d - 07�� <br />GEN° ONTRnCiOR V �!'�LnD� 55 � � C V ��ZIP/ PHONF. STf,TELIGENSE• <br />'� �� 93 °" ,� s� � •�i � ����',� �� <br />� —� GTY ZIP 1'NONE STATE UGENSE v <br />MLp1AN'�CALCGHIRA(,TOF MAIL�DDRESS <br />PLUMBP�GCONTHlJipB �dAR <br />GONTHACT PPIGE OF W09N �J M ' <br />/f- (N <br />DESG���E �YORN AN� SOJARE FOOTAGE INVOWED <br />0 <br />CI1Y <br />aaoroseouseoFow�oiK�a v <br />IEGAL OESGRIPiIOH OF PROPERTY I5110LYN �ELO W OR ATTAGN TWO GOPIE51 <br />�pT BLOCK � OF — <br />PpHCELTA%ID.NUMBER <br />A�DFE55, <br />TVPE OF <br />BATHTUB <br />LAVATORYIWASH BASIN) <br />SHOWER <br />KITC!1EN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URI�dAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACkFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />FOR OFFICI= USE ONLY: <br />FRONTSETBACK REARSETBACK <br />USE. IE <br />�I <br />tYoE �F CON57. <br />SIZE OP BI�G. <br />OCCUPAIJCV LOAD <br />HEASON <br />INTAKE OV <br />ITEM <br />PERAII <br />TOTni_ <br />LOT AREA <br />N0. OF STORIES <br />FIRE SPRRlNLLRS REO'0 <br />FIRE ALARM REOD <br />a�nNs �eaavEoov <br />���' <br />onle �1-7.,SU <br />�1/i� • <br />FEE <br />PNONE STAiELICENSEk <br />CONiACT PERSON AND PHONE NO <br />I HEREBY CER7IFY THAT I HAVE READ AND EXAM�IJED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND GORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WIi�H WHETHEF SPECIFIED HEREIN OF <br />NOT. TNE GRANTI�G OF A PERMIT DOES NOT PaESUME TO GIV[ <br />AUTHORITY TO VIOLATE UR CANCEL 7HE PROVISIONS UF AN�' <br />OTHER STATE OR LOCAL LAW REGULATWG CGN'.9 i RUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORI� THE 1VORK FOFi WHICH <br />APPLICATION IS MADE AND I COMPLY WITIi THF STATE <br />CONTR�CTORS LAW 1�7 R�J APJD $96200�'AC. <br />MECHANICAL <br />10. I TYPE <br />FORCED �IR SYSTEMS—O.T.U. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTIL�TION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAI FIREPLACE (WOOD BUI <br />FIREPLAC� INSERT <br />HEAT PUMP <br />GAS PIPING <br />5 <br />S <br />y <br />SIDE SETFiACN � PIFN <br />VACANTSITE 1'CW � <br />❑ YES � i N� BUILDING <br />OCGUPRNGY NOOfUWEWNGUH�iF <br />c9q1 PLUMBING <br />BASEMENT MECHANICAL <br />`,-� YES f-1 NO <br />HEIGHT LIMITATION AODITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURf,HARGf. <br />CITY OF EVERETT PusucwoaKs <br />LOCAL SIILES <br />TAX COUE IS 3105 TO7AL <br />FEE <br />SUB TOTAL <br />PEFMIT <br />TOTAL FEE <br />RBGCIPT NO <br />N <br />