Laserfiche WebLink
APPLICATII .+1 FOR CONSTRUCI DN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: 'J GAS ELECTRIC U _ l <br /> 259-8810 <br /> DEMOLITION ✓COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER �,��pRD Bf.�C,M��ADORESS U GITY ZIG PHONE S nU <br /> `'4�-0.--�-';_� (n221 �iL �Y PL EJfJ2ETT V✓A ��f52�� 35�- f�( <br /> TENiAI MAIL AJ�RESS CITY 21P PHONE <br /> PRCNITECT OR DESIGNER MAIL RODfiE55 GRV ZIP ?HONE <br /> GENERA�f.ONTRACTOR MAILADDRESS CITV ZIP PHONE STATELICENSEN <br /> OL✓.�/L � <br /> MECHMIICALCONTRAGTOR MAILADORESS CITY ZIP PNONE STRTEUGEWSEp <br /> PLUMBING CONTRACTOR MAI�ADDRESS GITV ZIP PHONE STATE LICENSE N <br /> CLASS Oi WORK <br /> NEW ADDITION ALTERATION REPAIR �. DEMOLITION WOODSTOVE,'FRPL INSERT BUILDING RELOCA`ION <br /> ,�d etc .0 Ow �L C77/ GONTRCT PERSON AND PHONE NO. <br /> CONTRACT PRICE OF WORK <br /> JESCRIBE WOFN FND SOUARE FOOTAGE INVOLVED <br /> �, , . � . • ,o fo�rF a r�Ky, <br /> PROPOSEDUSEOFBUILDING / I HEREBV CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> �ES�DENLE S/' � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGALDESCRIPTIONOF PROPERrv�SHOWN BELOW OR ATTAGH FOURCOPIES) PR��'ISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> �I I e�ocK Io20U oF BLd�I� P�.ALC W�RK WILL BE COMPLETED WITH WHETHER SPECIFlED HEREIN OR <br /> �oT NOT. THE GRANTING OF A PERMIT DOES NOT PRESl1ME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF APJV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.7HAT I AM AUTHORIZED BV THE <br /> OWNER OF iHIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE qND I CO".1PLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> X < / N� �O i Ufs'`G _ <br /> PRqIECT ADDRE55 s�crvnrur+e onre <br /> G221 gWrF PL.Atx.' ��,�a�s��Ess,��E�sENo -- <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> 2 WATER CLOSET(TOILET) O NC—AMNDLG UNITS—H.P. <br /> BATHTUB 0 FORCEDAIRSVSTEMS—B.T.U. M E.A. <br /> � `,Z LAVATORY(WASH BASIN) / � UNIT HEATERS—B.T.U. M <br /> SHOWER O CLvTHESDRVERS <br /> KITCHEN SINK&DISP VENTILATION FAN <br /> � DISHWASHER 1 RANGEHOOD. <br /> p LAUNDRV TRAV O WATER HEATEN <br /> p CLOTHES WASHER O WOOD STOVE <br /> p URINAL O METAL PIREPLACE&CHIMNEV <br /> 0 URINKING FOUNTAIN O FIREPLACE INSERT <br /> G FLOOF DRAIN O HEAT PUMP <br /> O BACKFLOW PREVENTERS CJ GAS PIPING <br /> p RGOF DRAINS—RAINLEADEFS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> SUBTOTAL $ SUBTOTAL $ � <br /> PERMIT $ PERMIT $ <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: 5��� �,��GT $ 121� 6C, <br /> FRONT SETBACK AEAR SETBACK SIDE SET�ACK PLHN CHEGK NUMBER FEE RECEIPT NO <br /> ' 20� S _ .��5 S—O �/D. JP 7'�)'�� <br /> usezoNe LOTqRE/ v y` vncaNrsiTe FEES VAWATION FEE <br /> 2-� 1�� �I�/ �O BUILDING � S S ,3/�2 .50 <br /> PIPE Of CONiS.ALLOWABLE IYPE OF CO i.ACTUAL OCCuenxLr NO ai owEi'-ixG uN!r5 <br /> seou� �I PWMBING � <br /> - J <br /> SIZEOFBLDG. NOAFSTORIES BASEMENT MECHANICAL � <br /> Z �J 25 3� <br /> OCCUPANCV LOAD FlRE SPRNKIEfi$RECD HEIGHT LIMsITATION ADOITIONAL PLAN CHECK <br /> /� N� 2v, SPRINKLER <br /> REASON FOR SPRINKLERS � <br /> STATE BUILDING SURCHARGE <br /> INTRKE BV PLANS APFROVE�BV CI7Y OF EVERETT PUBLIC WORK$ -�' <br /> LOCAL SALES ' <br /> ` ,J* �L TAX CODE IS 3105 70TAL ��5 � <br />