Laserfiche WebLink
APPLICATIL A FOR CONSTRUCT TAN PERMIT <br />CITY OF EERETT • DIVISION <br />3200 CEDAR STREET • EVERETTRETT. WA 98201 •259-8610 <br />❑ DEMOLITION ❑ COMBINATION / ,❑BUILDING 'VL MECHANICAL ❑ PLUMBING ❑ SIGN <br />Eyo re-W jYla f l j Eyere'f f- , ct� 8 <br />PRCiJE�T ADDRESS: <br />ItNANT MAIL ADDRESS CITY 71P PHONE <br />15ar_n Czcody <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY 711' PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY )B' PII(lNE STATE LICENSE I, <br />DeSager ior,34T, PO Box 815 W, r r[r 1n9, 1n= 9�1518 <br />MECHANICAL <br />Cl 'YSLj5Ae s �j Znc. 4oDb A1Y-xr+ 4kty 5 _S [, 0- ]R' q 7,1 Qf PIIba?ONE -94e�TATEUCENSETO�'Q <br />Air -SIB <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY !IP PHONE STATE LICENSE <br />CONTRACT PRICE OF WORK <br />$3�000 •' �� <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />�o r <br />CONGf.I PF.TI5011 AND PIIONE NO <br />inor la <br />1 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 GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WO'aK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X _ L�LTTYO(f 1 / 3 1 / 5 7 <br />PROPOEED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />DATE <br />SIG IDE �L�Gr <br />.oar-P�IFi <br />CITYB�INFSS LC.ENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />_ <br />UNITS <br />I <br />BATHTUB <br />_NC—A41NDLG <br />FORCED AIR SYSTEMS <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />I <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />_ <br />CLOTHES DRYERS <br />; <br />_ <br />DISHWASHER <br />I <br />_ <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />; <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />I <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />; <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />I <br />BACKFLOW PREVENTERS <br />; <br />GASRANGE <br />; <br />SINK (SERVICE — BAR. ETC.) <br />, <br />GAS PIPING <br />I <br />' <br />EXHAUST FAN <br />' <br />I <br />-- <br />I <br />I <br />I <br />I <br />- <br />I <br />I <br />I <br />I <br />_ <br />SUB TOTAL $ <br />SUB TOTAL $ <br />; <br />_ <br />PERMIT S <br />I <br />PERMIT $ <br />TOTAL FEE E <br />' <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />READ SETBACK <br />SIDE SETBACK <br />PI AN CIIFCK NIIMIVR <br />FEF <br />RECEIPT NO <br />6VII3 <br />USEZONE <br />L07AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />T <br />❑YES ❑ NO <br />pl111I11Nf. <br />I <br />- <br />HEIGHT LIMITATION <br />_ <br />NO OF DWELLING <br />SIZE OF BLDGRI <br />UNITS <br />PIUMRING <br />i <br />OCCUPANCY <br />NO OT 5111RIES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />' <br />GROUP <br />I <br />❑YES ❑ NO <br />ADDITIONAL PI AN CIU CK <br />' <br />FIRE SPRINKLER REO'D <br />REASON <br />OtNER <br />, <br />FIRE ALARM REO'D <br />REASON <br />STATE p111111II1R SNRCIIARGE <br />TYPE OF CONST <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PIIRIICW0RK9 <br />--'— <br />LOCAL SALES <br />--- - <br />TAX CODE IS 3105 <br />TOTAL <br />I <br />DATE <br />