Laserfiche WebLink
� APPLICATlQ J! FOR CONSTRI.ICT'"lN PERMIT <br />� TO BE COMPLETED IN BLl�CK INK-PLEASE PRINT �^��� <br />� <br />BUILDING DEPART,v1EN7 HEATING SYSTEM_J GAS ❑ ELECTRIC ❑ <br />2ss-aeio � y2 /SC,O Jl� -l3irk;�CCw�� lvu.,n�'C�IZ G��3'�3Q� <br />I 1 DEMOLITIGN iJ COMBINATION Ci BUILDING ' MECHANICAL ❑PLUMBING fl SIGN <br />OWMER IAAI�AODRE55 CiTY ZIP PHONE 1 {� (f� I\ <br />TE� � MA ADDflE55��'r ������ ���� CZD6 (p 1��� Dv <br />l"�.r•i <br />�tl�R�'��Yn�- � �� �ar ��<<nee�,l� tv�Frj' 9�2�5� 5i -nboy <br />AfiCh11TECTOfl0E51G Efl M�IL�DDPESS GTY 21P PHONE <br />GENERFLCONTRACTOFl M41lADORESS <br />MECNANICAL CONTRACTOR MAIL AODRESS <br />'�q��'fi� "r�YV1 �� � �., <br />PWl.1�INGCONTAA TOR MAILAODRESS <br />CONTFACT PRICE OF WORK <br />OESCRIBE I40PK AND SOUARE FOOT�GE INVOLVED <br />�v. ��tv�rc t, �to�r� — �n� zha� <br />PROPOSED 115L' OF BWLDIN <br />LEGAL OESCFIPTION OF PPOPERTV �SHOWN BELOW OR ATTACM Tl'!0 COPIES� <br />l0T — BLOCK Of — <br />PAACEL TA81.D. NUh18ER <br />o� � — � 33`j b?_ <br />CONSTPUCTION LOAN LEN�EF, AOORE55, <br />PLUMBING ' ' <br />O. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNORYTR.4Y <br />CLOTHES WHSHER <br />URINAL <br />DRINKING r�UNTAIN <br />FLOOR DkAli`! <br />bACKF'_ON' FficVEFdTERS <br />ROOF DRAiN&-RA'NLE�DIcRS <br />SINK IS`c�IVICE-3Ai!. L'�C.'! <br />SUB iC7tAL $ <br />PERIJIT 5 <br />70TAL f-EE S <br />F�JR OFFICE USE ONLY: <br />FRONTSETBAGN REAqSETBAGK <br />U�E ZONE LOT �FIEA <br />TVPEOFCO.'ST. NO.OFSrORIES <br />SREOPOL�G. FIRESPRINY.LERSFEO'D <br />OCCUPA9C1' LOAD FIRF ALAflM REa'0 <br />REAS'JN <br />INTAKEBY PLANSFPPROVEDBY <br />��M <br />DATE r/�%'d <br />n <br />CITV ZIP PHONE STpTE IILENSE u <br />CITv ZIP PHONE SIDTE LICENSE v <br />_ •Sl- '�. �=R1i1'L� �n.✓a C?ob� �Gz-M5u__ `�qr• <br />CITY ZIP PNONE STATELICENSEM <br />�CON7AOT�R3��NOPHON .A '.. %In��IU <br />GY'�_Ft�BY 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 TYPE OF <br />V✓ORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIIJ OR <br />NOT. THE GRANTING OF A PEP.?AIT DOES NOT PRESUME TO GIVE <br />AUTHOPITY TO VIOLATE OR CnNCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY Tq PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC70RS LANJ�i827 RCW AND 296200 WAC. <br />/ C�iYUU5iNE55UCEN5El:o <br />MECHANICAL <br />FEE N0. TYPE OF EOIIIPMENT <br />� AI�AIHNDLGUNITS-�H.P. <br />FORCED AIR SYSTEM'i—B.T.U. M E.A. <br />� UNIT HCATERS—B.T.U. M <br />� CLOTHES DRY'ER:i <br />; VENTILATION FAN <br />� RANGEHOOD <br />' WATER HEATBR <br />� WOODSTOVE: <br />� <br />� METAL FIREPLACE (W006 BURNING) <br />� FIREPLACE INSERT <br />� HEAT PUMP <br />' GAS PIPING <br />� EXHkU3TFAN <br />SIDE SETBACK rL:.N CHECN NIIMBER <br />Lll 8L <br />VACANT SITE FEES <br />❑ YES J NO BUILDING <br />OLCbV`AI.CY 1:00�01YE10'f�':�15 � <br />eaouv PLUMBING <br />BASEtdENT MECHANICAL <br />r YES u NO <br />HEIGHiLIIAITATION ADDITIONALPLANCHECK <br />STATE BUIL�ING SU(1CHARGE <br />CITY OF EVERETT �U�LIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />FEE <br />SUB TOTAL 5 <br />PERMIT S <br />TOTAL FEE S <br />flECEIPT NO. <br />FEE <br />