Laserfiche WebLink
A�PpL��CATI(—'1 �'OR C�d�i.�TR�CT� �N PEIRNA�T ��� — <br />TO BE COMPLEl'ED tN BI.�CK INK—PLEASE PRINT <br />l HEATING SYSTEM: O GAS '�ELECTRIC ❑ _ � <br />BUILDING DEPARTMENT � <br />259-8810 <br />❑ DEMOLITION CI COMBINATION ,�BUILDING MECHANICAL L�PLUM'R�ING (� SIGN <br />OWNER h1AIL�DDRE55 CITV :'n pM0!JE �j(�/�/ ���1.� Hp� <br />���Ne�.�U�—�-�i�PG�-[eErnW��-'�- �'r/�so 3 -- — -- -3aQ�h3� <br />TEWMT MAILAOORESS Z�P ��''���� � <br />� <br />�'on�, Ha.c,ravr� —!r_��'iin .�n��_� -- --. . 3c��,_—s8�3. <br />AFCHITFCTOFiDES1GN[R IAAIL�DDRESS / ���r �" '^ " <br />GENERAICONTFdCTOR MAILAOOflE55 CITY ZIP PHONE STATELICENSE� <br />� � ����� \ � ^_ <br />IAECHANICALCOHLRALTOR MAILADDRESS CITY ZIP PMONE ST�TELILENSE• <br />PLOMBINGCONTRFCTOF IAAILAOOfiESS <br />CONTRACT PR�CE OF WOflK <br />• lO�opO . <br />OESCRIBE WORN AND SOl1ARE FOOT�GE I, <br />• / /:i o <br />PROPOSED USE OF BUILDING <br />• _ �KA�-�— <br />LEGAL 7E6CRIPTION OF PROPE <br />�or— o�ocK <br />PARCEL TA% I D. N11R10ER <br />CONSTRUGTIONLOANLE� <br />ADDRESS <br />���y 7tP Pf10NE ST�TcLICENSEY <br />PERSON ANp PMONE NO. <br />t HEREBY CEflTIFY THAT I HAVE READ AND EXhMIVED THI� <br />APPLICATION P.ND KNOW Tf IE SAME TO BE TRUE AND l'�ORnECT, M; I <br />PROVISIONS OP LAWS AND ORDINANCES GOVERNIWG ?HIS TYPE C� <br />LOWORATfRCHNIOCOPIFS� WORK WILL BE COI.t?LFTED WITH WIIETHER SPEGIFIED HEHEW Ji: <br />NnT. THF GRANT�NG OF A PEfiMIT DOFS NOT PRF5VME TO GIVF <br />oF — AU7MORITY TO \'IOLATF OR :PNUF.L 7dE "An��IS�OMS OF ANY <br />OTHER STATE OR LOCAL LAW RE3ULh1'It1G CONSTHUClICV OR THE <br />PERFOFMANCE OF CONSTRUCT�ON. THAT I AM AUTHORIZEG BY THE <br />OWN[R OF THIS PROPERTY TJ PERFORM THE WORK FOR WHICH <br />APPLICATION IS M,1DE AND I COMFLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 Y:AC. <br />� <br />PNONE M OADEP <br />• ot'/"f� <br />$G4UU � DA��� <br />PL'JMBING � <br />N0. TYPE OF FIXTURE OR ITEM <br />W :T'R CLOSET (TOILET) <br />BATHTI!B <br />LAVATORY (WASH �ASIN) <br />� SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNORI'TRAY <br />CLOTHES WASHEfl <br />UFINAL <br />DflINKING FOUNTAIN <br />FLOOR DRAIN <br />� 4 ROOF <br />1 SINK ( <br />POR OFFICE USE ONLY: <br />conurcnranru REAflSETBFCK <br />USE20NE <br />�'/PE OF CJH57. <br />SIZE O� <br />��o0 5� <br />OCCUPAIlCY LOAD <br />13 <br />REASON <br />INTANEl3Y <br />SUB TOTAL 5 <br />PERPAIT S <br />TOTAL FEE 5 <br />FEE <br />� <br />0 <br />MECHANICAL <br />70. TYPE OF <br />A/C—A�HNDLG UNITS—H.P. �_ <br />FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br />UNIT IiEATERS—B.T.U. M � <br />--r— <br />CLOTHES DRVERS ' <br />VENTIlATION FAN <br />RA�GEHOOD <br />WATER HEATER <br />METAL FIFEPLACE (WOOD eUr+Nmu� <br />FIREPLACE INSERT � <br />--� <br />HEAT PUMP ' <br />GAS PIPING <br />EXHAUSTFAN ' <br />SUB TOTAL 5 <br />Lt1EC1:AJM8ER FEE Oi / I AECEIPTNOi <br />/] <br />� 1 / /7 .; � i/� � / <br />LOIAREA VAGANTSIit <br />❑ YES G NO BUILDING <br />NO.OFSTORIES atcuv;;:cr r:oolLw[WvcuM1irs <br />' catar � pLUMBING <br />FIPESPRINKLERSREOD BASEMENT MECHANICAL <br />ND G YES �CNO <br />FlRE ALARtd FEO'0 HEIGHT LIIAITATION ADDITIONAL PLAN CHECK <br />IVD ufHER <br />STATE BUILDING SURCHAR3E <br />PUINSAPPROVEODV CITY OF EVERETT Pl1BLICWOFiKS <br />�M LOCAL SALES <br />DATE G�I R�9s, TAX CODE IS 3105 TpTA� <br />