Laserfiche WebLink
APPLICATIC J FOR CONSTRUC7. JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />N <br />BUILDING DEPARTMENT <br />259-8810 <br />_ DEMOLITION <br />OWNER MAIL <br />HEATING SYSTEM: U GAS U ELECTRIC <br />COMBINATION BUILDING MECHANICAL PLUMBING <br />ADDRESS CITY ZIP PHONE <br />SIGN <br />mn,U QUPe � ?WWk k CITY ZIP PHONE <br />alb{} L18ACitGt� � � 2731 WMgPEAX) S']Cs 50®-84dw <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />ZIP PHCNE <br />uaaj III 50..uv_4c5w <br />98W4 <br />! 2Z5-5S6S <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE STATE LICENSE A <br />Sbl_ cORP <br />MECHANICAL <br />P.O " 1165- <br />t-U.AVLM Wl6- 9&2q <br />6v4 -110W 5M4Q ** 2 51 bo <br />CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE STATE LICENSE IT <br />WA <br />PLUMBING CONTRACTOR <br />MAIL AUDRE SS <br />CITY ZIP <br />PHONE STATE LICENSE A <br />C__ l`I <br />CLASS OF WORK <br />x NEW ADDITION <br />ALTERATION <br />REPAIR n DEMOLITION <br />F-I WnnngTAVP/PMOI IMecoT 01 H. n,A,c <br />CONTACT PERSON PHONE NO. <br />CONTRACT PRICE OF WORK � <br />�AND <br />L. $jgmca -m&-d w <br />, <br />`�•Mp ✓GD i�'1 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />uA�v�t~ou GOL�!(R. Ur ib "Qlq Aym Le <br />MIA. __.>W ,L J <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 BELOW OR ATTACH FOUR COPIES) <br />/SHOWN <br />LOTJ (— BLOCK OF �a>�ll•r �1IE1z8Z'f <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 />CO RACTORS LAW 18.27 CW AND 296.200 WAC. <br />X �. G bD g 3 <br />SicmA m DATE <br />PROJECTADDRESS <br />APfRox. .�7e1—cowry -AVIS. <br />—lbl-3 71S <br />,'TIP, Is'M Is. It NIF „, <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 />; <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />I <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />; <br />SHOWER _ <br />CLOTHES DRYERS <br />, <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />_ <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />; <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />, <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />' , <br />FLOOR DRAIN <br />HEAT PUMP <br />, <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />, <br />SINK (SERVICE —BAR, ETC.) <br />, <br />' <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />PERMIT 5 <br />I <br />PERMIT $ <br />; <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />O <br />REAR SETBACK <br />d <br />SIDE SETBACK <br />PLAN CHECK% MR <br />"�J�7// 9BE <br />1E@ <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />1�7 1�') <br />TYPE OF CONTS. ALLOWABLE <br />f <br />TYPE Of ACTUAL <br />•TT—� <br />STORIES <br />=UPANOY <br />ouv <br />NO MMUINGUN,TN <br />PLUMBING <br />5FB 12E OJLLDG;4 J_ <br />L1^K'YJSYL <br />NO OF I <br />,Z <br />BASEMENT <br />yk�;` <br />MECHANICAL <br />-- <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRN{K'L,E.RS RED HEIGHT LIMITATION <br />�j 15 ' <br />REASON FOR SPRINKLERS <br />SPRINKLER <br />i <br />STATE BUILDING SURCHARGE <br />INTAKE BY 14 <br />LAPS APPROVEDEW <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />' <br />TOTAL <br />