Laserfiche WebLink
1 APPLICATIGel'OR CONSTRUCT 4'4 PERMIT n <br />TO BE COMPLETED IN INK -PLEASE PRINT <br />the EPeTpreen <br />CITY OF <br />everett I HEATINGSYSTEM: UGAS ❑ELECTRIC U <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS <br />BOEM4 H10Af SAY ASUVIII&Y <br />CITY <br />a 04 4o-ZS <br />ZIP PHONE <br />tvg-& r.w�. 9Y301 <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERALCONTRACTOR <br />AIVS77N CotjA4NY <br />MAIL ADDRESS <br />/015- 47n1 4se, <br />CITY <br />EVERE oww. <br />ZIP <br />7820, <br />PHONE LICENSE) <br />266.66w 223-01-AU-$T-lc7jwj <br />MECHANICAL CONTRACTOR <br />IOSCO f/ft tW?yCnpN <br />MAIL ADDRESS <br />/o9/0-117nv <br />CITY ZIP <br />jff. A/.E• K/RKatAV &V4 91073 <br />PHONE LICENSE) <br />W-9(S4 CoSCoFPIIoNM <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />C S OF WORK <br />ucw I AnnITInN I I ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT Li BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO 27-16 <br />CONTRACT PRICE OF WORK MA1kt <br />AL. irk <br />OESCRIBE WORK AND SQUARE FOOTAGE) LVED <br />PROPOSED USE OF BUILDING <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 />LEGAL DESCRIPTION OF PROPERTY )SHOWN BELOWOR ATTACH FOUR COPIES) <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 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 WAC. <br />o LL� <br />c-1LJy Vic 'i.4 <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT OTE <br />42.7 <br />Aulx <br />oC*feo fAt nav if 02+lG I+ <br />PR0JECVAJ5DAIESS-- <br />17 <br />APPLICANTS CITY II LIC::N5F N0. AND BU5NVE55 NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET( <br />A/C-MHNOLG UNITS-H.P. <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 IL DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />_ <br />GAS PIPING <br />.�. <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />, <br />SINK (SERVICE -BAR. ETC.) <br />I <br />SUB TOTAL $ <br />SUB TOTAL <br />PERMIT $ <br />PERMIT S <br />TOTAL FEE $ <br />TOTALFEE $ <br />run urrouc vac <br />vnN... <br />FEE <br />RECEIPT HO <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLANC.,L[R NUMBER <br />'S s <br />a/ s0 <br />6 7� �� <br />USE ZONE <br />LOT AREA <br />VACANT SI1E <br />FJE-Eg <br />VALUATION <br />FEE <br />_ <br />BUILDING <br />I <br />TYPE OF CONTS ALLOWABLE <br />TYPE Of CONST ACTUAL <br />mcupwY <br />NOMOAI .Ixt. UNITS <br />Oxall <br />PLUMBING <br />_ <br />MECHANICAL <br />I <br />' <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE SPRNKLERS REGD HEIGHT LIMITATION <br />OTHER <br />T <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />PUBLIC WORKS <br />i <br />.^ <br />=COOEIS <br />I '�� <br />TOTAL <br />/ ; V <br />