Laserfiche WebLink
�v..- �''�� <br />AI�PLICATII.��i FOR CONS � FaUC��e01� PERMIT <br />Ihe Evergreen <br />CITY OF <br />ev��rett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-8810 <br />❑ DEMOLITION O COMBINATION ❑ BUILDING �ECHANICA <br />OWNER MAILAODRE55 � CITY Z�P <br />uD, w<< —EU�PGr?s�.v W� — c,2c—w�� <br />❑ PLUMBING <br />everett <br />e <br />❑ SIGN <br />TENANT MAILAPDRE55 CIN ZIP PHONE <br />Ak�''x' < � <br />ARCHITECTORUESIGNER MAlLAODReSS CITY ZIP PHONE <br />GENE�ALCONTPACiOp MAILADDqESS CITV ZIP PHONE LICENSEM <br />MECHANICALCONTRACTOR MAILA�OPE55 CI7Y ZIP PHONE UCENSEI <br />PLUMBINGCONTRACTOR MMLADDRESS CITV ZIP PNONE LICENSEM ���LCS/��/yg�� <br />�iLLS l�lu�yl3i v L /�C� (:So `' �' ���I���,�'�'-'�'z�� L.J�=1 ��S�a��'1�43�+4vc <br />�cus OF WOPK <br />EW ❑ ADDITION ❑ ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br />TENANT IM�OR IMEAIOR HEMODEL ONLV <br />CONTFiACT PflICE OF WOAK: <br />; � OESCRIBE WOflH AND SWARE FpOTAGE INVOIVED <br />�d PROP E� USE F BUI� pING <br />i I` I�CS � , <br />� LEQAL DE RIPTIO F PROPERTV (SHOWN BELOW C <br />� LOT BLOGN OF _ <br />� YLUMtlIIVG <br />�; NO. TYPE OF FIxTURE OR <br />j WATER CLOSET (TOILET) <br />BATHTUB <br />� LAVATORY (WASH BASIN) <br />SHOWEA <br />1 KffCHEN SINK 8 DISP <br />' DISHWASHER <br />� LAl1NDRY TRAY <br />' CLOTHES WASHER <br />UHINAL <br />DRINKING FOUNTAIN <br />' FLOOR DRAIN <br />- BACKF!_OW PREVENTERS <br />. flOOF DRAINS—RAINLEADER <br />� SINK (SERVICE—BAR, ETC.) <br />FRONTbETOACK <br />USE ZONE <br />IYPE OF CONSi. ALLOWABLE <br />� SIZEOFBLDO. <br />. OCCUPANCVIOAD <br />i <br />PEASON FOR SPNINKLERS <br />' APPLI ATION ACC. BY <br />COPIES) <br />CONTAGTPtH50nnrvurnunen�. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TH'c SAME TO BE TP,UE AND COflPECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PflOVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TFIIS PROPERTY TO PERFORM THE WORK FOF WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATU(iEOFCONTpAC10RORAUTHORREDAGENT DATE <br />X ��_'-�� .._�r�-�'�� � <br />APPLIL�NiS CITY BUSINESS UCENSE NO. AND OUSINE55 NAME <br />NO. <br />AIC—A/HNDLG UNITS—H.P <br />FORCED AIR SYSTEMS—B� <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD . <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPI.ACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PERMIT 5 � <br />TOTAL FEE $ ' <br />PERRSETOACK SIOESETBACH PLANCHECKNUMBEP <br />LOTAREA VACANTSITE FEES <br />LI YES U NO BUIL�ING <br />TVPEOFCONST.ACiUAt acur,mcr No.orwrtuixauxns <br />�POUr pLUMBING <br />NO.OFSTORIES BASEMENT MECHANICAL <br />f_l YES ❑ NO <br />FIRESPRNKLEfl5REOD HEIGHTLIMITATION OTHER <br />U YES ❑ NO STATE 6UILDING SURCHAFGE <br />STATE ENERGY SURCHARGE <br />PIANSAPPROVEDBY CITY OF EVEREIT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />M E.A. <br />TOTAL FEE 5 <br />FEE FECEIPTNO. <br />i <br />i <br />i <br />„ <br />