Laserfiche WebLink
. <br />` APPLICATIO�1 FOR CONSTRUCT'`1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYS7EM: ] GAS J ELEC7RIC ,J <br />259-8810 <br />' DEMOIITION COMBINATION 1 B�JILDING Ci MECHANICAL I' PLUMBING SIGN <br />OIVNER MAILA�DRESS LiTY bP PNONE <br />�f/oi7LS .�ivK4Af� S.SO� �.7' �A�4 h� <br />TENANT IdA4A0DPE55 � CITV ZIP PNONE <br />ARCHITECTORDESIGNER MAILADDRE55 dTV 21P FNONE <br />� <br />GENERALGONTRACTOR M4ILP�DFE55 CITv 21P PHONE STATEL�CENSEK <br />.jf. S�wN� C�n.,A:.�l P,�• B� tv�3 �o�,[ `'/A�si 3�5� ��'1 S�S�JICN I'7oc� <br />MELHRNICALCONTRACTOR �AAiIApOAE$5 CI7V ZIP PH�NE STATEULENSE• <br />l-jl-� <br />PLUMBINGCONTRRCNR MAILA�DRE55 CITY ZiP PHONE STAiELICENSEP <br />CONTRM1GT PRiLE OF WOPH <br />Ci. //O <br />SOUAflEFJOTAGEINVOLVEO <br />G <br />USE DF BUIl01NG <br />LEGAL OESCRi�T10N OP PROPERTv �SHOWN BELOW OR ATTALH TWO COPIES� <br />ior eiaK oF <br />PARCELTAXIO NUMBER <br />CONSTflUGT10N LOAN L[NDEF. P��RE55. TREPHONE NUMBEF <br />� <br />WATER CLOSET <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DR�IN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADE <br />SINK ISERVICE—BAR, ETC.) <br />SUBTOTAL S <br />PERMIT $ <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: S�pK� OF <br />FFONTSE7BACN REAR EETB.GK SIDE <br />USE ZONE <br />7YPE 0�� <br />SR[ OF BLDG. <br />l5 � <br />OCGU�'� <br />K <br />REASON <br />INiAKE BV <br />LO7 AREF <br />NO.OF STURIES <br />2 <br />FlRE SPRINeLE85 REO'D <br />�� <br />FIRE ALARM REOD <br />N� <br />PLANS P�OV[D BV <br />� <br />�FTE 'I � � � .E: e <br />FEE <br />COMACT PERSON AND FHOhE NO <br />(� � /Tr0/�G <br />I HEREBV 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 TVPE OF <br />WORK WILL BE COMf'LETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUf�IE TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEF STATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORI( FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />„ ��G .!i� ��fl4ri <br />NO. <br />NC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. 1A E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />i WVVUJIUVt <br />METAL FIREPLACE (WOOD BURNING) <br />; FIREPLACE INSERT I <br />� <br />� HEAT PUMP � <br />� — <br />; GAS PIPING ' <br />� EXHAUSTFAN <br />� � <br />� <br />SUBTOTAL $ ; <br />PERMIT $ <br />TOTALFEE $ <br />R..��'i'b pFR 5���ti �z�o vBc <br />PIANGNEGKNUMOFR FEE R[LEIPTNO. <br />VALANT SITE <br />�'�. YES C NO <br />OCNn]qCV NOO��kELLIryGUNIfS <br />B�SE�dENT <br />-�ES .^��. NO <br />HEIGHT LIMIT�TION <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHEF <br />STATE BUILOING SUFCNARGE <br />PUBLIC WORKS <br />TOTAL <br />