Laserfiche WebLink
.-� <br /> APPLICATION FOR CONSTRUCT�ON PEiiiMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> Bl'SLDING DEPARTMENT HEAT•'NG SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> 253•88;0 <br /> �G.DEAqOLITION I COMBINATION BUILDING ;MECHANICAL PWMBING ' SIGN <br /> Oi4NER MAILADDRESS CITY 21P pHONE <br /> ��� IAY 27�J_1�TM{Llflt �11�L�,�1/ Il1A— ��r � � 02G27_ <br /> TENANT MAIL A�ORE55 GTV 21P PHONE <br /> AHCMITECTORDESIGNER M�ILADURE55 dTY 21P PHONF <br /> G!NERAL CONTFRCT4R MFIL�UURE55 CIN 21P PHONE STA1 E LICENSE• <br /> _'Q 'Y�G_ 'L�T�AA�N�9 <br /> M'cCHPNICALCONTflACTOR MAILAUDRESS GTV ZIP PH�NE STRTELICkNSEC <br /> PWMBINGGONTRACTOR MAILADDP[55 GTY 21P PIIONE ST�TELICENS[t <br /> C1A550F WORK <br /> I -I NEW I I ADDITION ��. ! ALTERATION i -; REPAIR X DEMOLITION � ! WOODSTOVE/FRPL INSERT I BUILDING RELOCATION <br /> GOMTAGT PERSON AND PIIONE N . <br /> CONTPACT PRILE OF WORK <br /> DESCNiBE WORK AND SOUARE FOOTAGE INVOLVED <br /> PROPoS[OUSEOFBUILDING I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE S.4ME TO 9E TRUE AND CORRECL ALL <br /> LEGAL DESCRIPTIONOF PROPERN�SHOWNBELOW ORATTACHfOURGOPIES) PROVISIONS OF l.�iWS AND ORDINANCE:�GI.IVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETI�ER SPECIFIED HEREIN OR <br /> iot__f.Q_ e�ocK �25 . oF NOT. THE GRANTING OF A PERMIT DOE� NOT PRESUME TO GIVE <br /> AUTHOR�TY TO VIOLATE OR CANCEL Ti;E PROVISIONS OF AIJY <br /> OTHER STATE OR LOCAL LAW REGULATIN�3 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.TI?1T�AM AUTHORIZED DY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADC AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> JbH 1-i rr� <br /> L. 3 ��/ Z _ <br /> PR0.IECTRDDFESS ,1'` sa siu�r� O wrc <br /> L�M� cirveus�ui¢cwsEuo <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EQUIPMENT FEE <br /> WATER CIOSET(TOILET) � A/C—AIHNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. IA E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRVERS T <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> --�— <br /> LAUNDRV TRAY WATER HEATER ; <br /> CLOTHES WASHER � WOODSTUVE <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> FLOOR DRAIN J_ HEAT PUMP <br /> BACKFLUW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EJ(HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; ; <br /> � <br /> � <br /> � <br /> -T <br /> SUB TOTAL $ ; SUB TOTAI. $ ' <br /> PERMIT $ � PERMIT $ i <br /> TOTAL FEE $ ' TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBRCN RERRSETBACK SIDESETBACN PLANCHECKHUMBER FEE RECEIPTNO, <br /> 3mo <br /> USEZONE LOTAREA VACANi51TE FEES VALUATIQN FEE <br /> 9UILDING � <br /> 7VFEOFCONTSALLOWABLE 7"PEOFCOIIST.R�TUPL oCCUwN[r HopPMIUNCUNnS i <br /> cnav � PLUMBING ; <br /> SRE OF BLDG. NO.OF SIDBIES BASEMENT MECHANICAL � <br /> OLCUPANCY LOAO FIPE SPRNKLERS RE�'0 HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> � <br /> SPRINKLER ' <br /> i <br /> PE�SON FOR SPRINKLERS � � <br /> STATE BUILDING SURCNARGE <br /> INiRNEBV PLANSAPPROVE78Y CITY OF EVERETT PUBLIC WORKS � <br /> LOCAL SALES , <br /> TAX CODE IS 3105 rora� <br />