Laserfiche WebLink
�+, r <br /> APPLICATI�.N FOR CONSTRUCI �ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVEREl7', WA 98201 •259-8810 <br /> ❑ DEMOLITION Cl COMBINATION Cl BUILDING ❑ MECHANICAL ❑ PLUMBING ,'F4�SIGN <br /> PROJECT ADDRESS <br /> �1�Z Et/pi ��-eYl �L�Y.� <br /> OWNER MAILADDRG55 CITV � .`iP PHONE <br /> �',�lrisfic4l�. �a� -��-.v.2. 2zz`7 Ev�t/ �,�'1� �kZc3� 2�7_-oi.�`� <br /> TENANT /� M�II.q00RESS CITY 21P PHONE <br /> ��'CSSD ( OvJr'Jr��lovl, SAn/IF S.4.t�E <br /> ARCIITFCTOROESIGNER MAILAOURE55 QTV ZIP PHONE <br /> GENERPLCONTRqCTOR MAILA�DRE55 CIN ZIP PHONE STATELILENSEx <br /> MECHANICALCONiR�CTOR MAILA�DRE55 CITY ZIP PHONE STATELICENSE� <br /> PLUMBINGCONTRACTOR MAILADDRE55 Cltt ZIP PIIONC STATELICENSEN <br /> CONT�T PRICE OF WORN � <br /> ZSGY� HEATING SYSTEM: ❑GAS ❑ ELECTRIC ❑ <br /> �ESCRIBE WORK AND SOUARE f00TAGE INVOLVED CONT T PERSONANO PHONE O. <br /> e s �ti - - u.d. v zh`czv. v �z -c�13�1 <br /> �'. c�' _ • <br /> ` t p i g' . <br /> I HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br /> PROPOSE7 USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAV:�S i.ND OFDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCflIPTIONOFPqOPERTV�5H01YNBELOWOflATfACHTWOCOPIES� NOT. THE GrIANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oi BLOCK oF AUTHORIT'f TO VIOLATE OR CANCEL THE PqOV�SION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIDN.THAT I AM AUTHOAIZED BY THE , <br /> OWNER OF THIS PROPERTY TO PEqFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%I.D.Nl1MBEfl CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSiFiUCTON LOAN LENDER,ADDRE55.TELEPHONE NUM9EF X�f/(�`� �— S� — /S <br /> SI�6RE UATE <br /> . , CIN BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEC NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. i <br /> . BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � <br /> . LAVATORY(WASH BASIN) i HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP i CLOTHES DRYERS ; <br /> DISHWASHER � VENTILATION FAN i <br /> LAUNDRV TRAY ; RANGE HOOD � <br /> � <br /> CLO�fHES WASHER � WATER HEATER i <br /> URINAL ' WOOD STOVE � <br /> URINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUfiNING) � <br /> BACKFLOW?REVENTERS � GAS FIREPLACE ' <br /> � <br /> _ SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ; GAS PIPING � <br /> i EXHAUST FAN ' <br /> i , <br /> i , <br /> i , <br /> ' � � <br /> SUB TOTAL S � SU�TOTAL S � <br /> PERMIT S i PEHMIT S i <br /> TOTALFEE S � TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> FflONT SETBACK �.� RE SETB � $IOE�ET�4CK PLAN CIIECN NU OEfi FEE �O RECEIPT NO�/ <br /> S /%/i l / <br /> use V � �OTaFlEn vpCnNisrzE FEES YALUATION FEE <br /> nves n No BUILDMG � �' ; <br /> � <br /> HEIGHT LIMIipTION NO.OF DWELLING SIZE OF BLDG/CI. i <br /> UNITS <br /> PIIIM�ING j <br /> OCCIIPANCY NO.OFSi0RIE5 OCCUPANTLOAD BASEMENT <br /> GROUP h1ECHFNICAL I <br /> ❑YES ❑ NO � <br /> FIREALARMREO'D R�ASON ADGIPONALPLANCHECK � <br /> i <br /> OTIIER i <br /> FIRE SPRINKIER REO'D FEASON � <br /> STATEBUILDINGSURCHAflGE � /, <br /> V <br /> TVPEOFCONST p1.AN5 qPPOVEDBY CITYOFEVERETT PUBLICYfORKS i <br /> �Iti" LOCAL SALES ' <br /> onre 5 - �I _y S TAX CODE IS 3105 TOTAL �) J� - <br />