Laserfiche WebLink
APPLICATIC ; FOR CONSTRUCT, JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑� <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION <br />COMBINATION <br />BUILDING <br />MECHANICAL PLUMBING I I SIGN <br />OWNER <br />/L <br />MAIL ADDRESS <br />Gu ) /✓1 i7Z')�1AT <br />CTY <br />,�F ^ <br />ZIP <br />Eo_r-LAn <br />PHONE <br />E..KA-. `�i/'�' <br />' --s-1'-7p <br />TENANT <br />MAILDRESS <br />CITY <br />ZIP <br />PHONE <br />A� <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />/(n/ <br />N CITY pp <br />-IIIIY"<'+r <br />ZIP <br />PHONE <br />Qr/Lf <br />iT-?i.'i <br />,'o MAn/ LN-:I.RS�RS <br />_.-:n•T:T:v/1 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSEE <br />LcJ <br />so r - 3a e G c <br />✓. � 9 r73 y <br />7G 7-Boos- <br />/77GI<IAJ is 3No <br />/ MECHAMCA�IBACTOft <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSER <br />CLASS OF WORK <br />nninnAl !' AITCOATInM REPAIR OFMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />CONTRACT PRICE OF WORK <br />CONTACT PERSON AND PHONE NO <br />-- <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />PROPOSED USE OF BUILDING <br />r'^ 2 0. „ + �,,„H I+T n; �r+..••7 (,� T �Q r ' <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESI)ME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG. <br />7 <br />X i/ , �*.E/1ti�, • /0 2 yl <br />LEGAL DESCRIPTION OF PROPERTY ISNOWN BEIC.I OR ATTACH FOUR COPIES) <br />LOT BLOCK OF <br />PROJECT ADDRESS%� �Z E•' <br />T 1 Ll ; L y / V ' It, L L's"'E. ;.r ! <br />SroNAiw11 DATE <br />CITY RVSINFSS ICI NSI NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A,HNDLG UNITS—H. P. <br />I <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T..U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />i <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $1 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />USE ZONE <br />LOT AREA <br />TVPEOFC0415 ALLOWABLE <br />TYPE OF CONST AI <br />SIZE OF SLOG <br />NO OF STOPIE: <br />LOAD FIRE SPrrNKLERS RED <br />Y� <br />I SPRINKLERS <br />Coo F <br />BY I PLANSPPROVEDBY <br />SIDE SETBACK <br />PLAN CHE KNUMBER <br />O.? LD <br />VACANT SITE <br />FEES <br />BUILDING <br />acO", <br />cRRue <br />Nr or cw:wN: uw�s <br />PLUMBING <br />MECHANICAL <br />BASEMENT <br />HEIGHT LIMITATION <br />A990116NAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />�1 <br />