Laserfiche WebLink
APPLICATION. FOR CONSTRUCTr IN PERMIT <br />IAe Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />DEMOLITION <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />everett <br />e <br />I HEATING SYSTEM: U GAS U ELECTRIC U I <br />COMBINATION BUILDING <br />PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />BGEIN6 Y/4►N SAY ASSEMBLY 804 40-2S EV�.�,✓A. 9p=ol ?24:-IGf.� <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CTY ZIP PHONE <br />GENERAL CONTRACTOR <br />AUSTIN COMPANY <br />MAIL ADDRESS <br />/0/S-47>aT 41r4 <br />CITY ZIP <br />EVE,t�w4. 962ot <br />PHONE <br />266.66m <br />LICENSE IF <br />223-o1-Au-ST-1e73711t1. <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE <br />COtep fl" tvW?f6j*W <br />/o9/0-/177w <br />i4.A/.E. A7.�M41 <br />9/073 937-9154 <br />wSCoFPljoNM <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE <br />I ADDITION i ALTERATION REPAIR DEMOLITION WOODSTOVEJFRPL INSERT L; BUILDING RELOCATION <br />Rr <br />CONTRACT PRICE OF WORN .4 PRiA/kl <br />CONTACT PERSON AND PHONE NO <br />27-9L S <br />DESCRIBE WORK AND SQUARE FOOTAGE I 'ADLVED <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 />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />4►n sn^� yZ4 <br />X t#fto fAPE Atayscrmaw 10 02+ 14 �¢ <br />--.-- <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCK OF <br />-f <br />]ZODF L(3xJFiS S 2 <br />L <br />6 4O -Z S <br />PROJECT ADDRESS <br />rl'PUCANISCITY Ifil SinE'.E LIC'NSE NO AND UU51::E 55 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-A/HNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <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 />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />HEAT PUMP _ <br />T— <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />T <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC.) <br />X[RrS / t <br />2_w - da <br />SUB TOTAL $ <br />SUB TOTAL $ <br />i- <br />PEPMIT $ <br />- PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLANCN CKNUMBER <br />FE <br />RECEIPT 140 <br />'15'r6 <br />USE ZONE <br />LOTAREA <br />VACANT SIZE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE 0I CONIS Al10WAB.E <br />IYvf 01 CON51 KIBAL <br />'Xm' <br />'F <br />PLUMBING <br />SIZE OF BLCQ <br />1.0 OF STORIES <br />BASEMENT <br />MECHANICAL <br />I <br />ADDITIONAL PLAN CHECK <br />—• <br />OCCUPANCY LOAD FIRE EPRNKLERS REDD HEIGHT LIMITATION <br />OTHER <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PUN <br />APPROTEDBY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />— <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />u <br />