Laserfiche WebLink
���' everett <br />APPLICAT N FOR CONSTRU�'ION PERMIT <br />TO BE COMPLETED IN IDIK—PLEASE PRINT � <br />Ihe Evolpraen <br />CITY OF <br />ever�tt � <br />BUILDING DEPARTMENT <br />259•8810 <br />n DEMOLITION ❑ COMBINATION <br />OWNEA <br />,� � <br />HEATING�SYSTEM: ❑ GAS ❑ ELECTRIC O <br />❑ BUILDING <br />CITV 2�P <br />❑ PLUMBING <br />❑ SIGN <br />� <br />TEN N� '1 MAILAD�RESSSPRCE 1�'Z' ��IY ur .••-.._ <br />n ` ' 7 � <br />AqCHITECT ROESIGNER' MAILAOOflE55 QTY 21P PNONE <br />QENEMLLONTRAC70�R MAILADDRE55 CITY ZIP PHONE LICENSEN <br />''�Il.... � SI(' 10 <br />MECH/�NICAICONTRACTOR MAIL OOflE55 CITY ZIP PNONE LICENSE� <br />?��n�si�E�uTe �874 �sa,.dA�NE �� A qSd�� ��a.�a� C�L155i'ril 158t� <br />_....._..._,.,.........�..,, .�.�� .�nocee GIN 21P PMONE LICENSCP <br />GUSS OF WORK <br />� NEW ❑ ADDITION �j ALTERATION I�I REPAIR <br />DESCRIBE WORN AND SOUAPE FOOTpGE INVOLVED <br />intta00 R„�►.Q�frean �ud'�i5irt}z+�'iC <br />�Pfl0 OSEDUSEOFBUIL— D� � �}-- � <br />t�y�Lu—a.0 /i� <br />LE4ALDESCflIPiIONOFPROPEfl (SIIOWNBELOWOflAiTACHFf <br />�pT BLOCK _ Of <br />PRQIEGTADUFE55 `/�-� � A <br />0 <br />PLUMBING <br />N0. TYPE OF FIXTURE OR <br />WATER CLOSF.T (TOILET) <br />BATHTUB <br />LAVATORY(WASH BAS�N�- <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNfJRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADER <br />SINK (SERVICE—BAR, ETC.) <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FHONTSETBACN REARSETOACK <br />USEZONE LOTARE4 <br />TYPEOFCONiS.ALLUWABLE TYPEOFC075CAC' <br />SIZEOFBLD(3. NO.Of�STORIES <br />HEAS�N FOIi <br />FIFE <br />PUNS APPROVED BV <br />�� <br />SETBACK <br />f I DEMOLITION 17 VJOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />CONiRCTPEfl50NAN�PFjONENO � _ � � � _ . � _ <br />I HEREBY 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 COVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br />PERFORMANCE OF CON5TRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTFACTORS LAW 1B27 RCW AND 236200 WAC. I <br />SIGNATUFEOFCONTNACTORORAUTHORIZEUAGEN7 DA1E <br />X i�l/In �///{�.�_....�.. A ��i�1_Q%� <br />ANO <br />FEE NO. TYPE OF E�UIPM <br />i A/C—NHNDLG UNITS—H.P. <br />' FORCED AIR SYSTEMS—B: <br />—� UNIT FIEATERS—B.T.U. M <br />—•— <br />� CLOTHES DRYERo <br />; VENTILATION FAN <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY' <br />FIFEPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN - . £v <br />VACANT SITE FCGa <br />BUILDING <br />pLCpOAYCY NO.MPMIUNGUN115 <br />G900v pLUMBING <br />BASEMENT MECHANICAL <br />HEIGMT LIMITATION ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />��cn� sa��s <br />TAX CO�E IS 3105 Torn� <br />SUB TOTAL $ <br />PERMIT $ <br />H <br />�5 ? — <br />� <br />