Laserfiche WebLink
APPLICATILA FOR CONSTRUCI.ON PERMIT <br />�W <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-BB10 <br />1-1 DEMOLITION COMBINATION I I BUILDING I MECHANICAL PLUMBING 11 SIGN <br />PROJECT ADDRESS �2707 CO) //-L '7Jc�- <br />OWNER MAILADDRESS CITY ZIP PHONE <br />�z '•fir-n �u�ar�- � 70/ ��y ,dv� ��� 9�� / <br />ARCHITECT OR DESIGNER MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR MAILADDRESS <br />CRY <br />LP <br />PHDNE <br />STATE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSED <br />CONTRACT, RICEOQF WORN <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INyOLV <br />CONTACT PERSON AND PHONE N0. <br />ra- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�f <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />PROPOSED USEq BUILDING <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK OF <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 />CO TRACTORS L W 18.27 i1CW AND 296.200 WAC. <br />PARCEL TA%LD. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />SIGNATURE DATE <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />1 <br />A'C—AIHNDLG UNITS—H.P. <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />1 <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS—B.T.U. M <br />' <br />KITCHEN SINK & DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />i <br />EX14AUST FAN <br />SUB TOTAL $ <br />) <br />SUB TOTAL $ <br />i <br />PERMIT S <br />PERMIT S <br />' <br />TOTAL FEE $ <br />TOTAL FEE S <br />' <br />RECEIPT NO. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHEC ��-7 <br />FEE (9S <br />r <br />/f <br />FEES <br />VALUATION <br />FEEIr <br />USEZO -r� <br />LOTAREA <br />VACANT SITE <br />BUILDING <br />❑YES ❑ NO <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDGITL <br />' <br />I <br />UNITS <br />PLUMBING <br />MECHANICAL <br />N- <br />OCCUPANCY NO OF STORES <br />OCCUPANTLOAD <br />BASEMENT <br />GROUP <br />❑ YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />{ <br />1 <br />FIRE ALARM REO'D <br />REASON <br />•.. • <br />Y•.a <br />OTHER <br />1 <br />FIRE SPRINKLER AEG <br />REASON <br />STATE BUILDING SURCHARGE <br />T_ <br />PUBLIC WORKS <br />I <br />TYPE OF CONST <br />PLANS AP ROVEOBY <br />CITY OF EVERETT <br />V <br />LOCAL SALES <br />/ <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />