Laserfiche WebLink
APPLICATI,,- N FOR CONSTRUCAIii EOM PERMIT'S` <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •25P 8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING LI MECHANICAL C PLUMBING <br />PROJECT ADDRESS: LL71 sL <br />❑SIGN <br />... <br />OWNER MAIL ADDRESS - -- <br />CITY TIP PHONE <br />1A. <br />(,L (�_ <br />FOOTAGE INVOLVFn <br />USE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OTACH IVIO COPIES( <br />LOT BLOCK <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />Cm <br />CITY -- TII' PIIDNE STATE LICENSE r <br />PHONE STATE LICENSE <br />3--- Lf�3-oto2a C2h/£PHo5YS3 <br />PHONE STATE LICENSE <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />,.oN mla PERSON AND PHONE NO <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 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 WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS <br />LAW 18.27 RCW AND 296.200 WAC. <br />$IGNA -F cJ�ce�. <br />BATE <br />CITY BUSINESS LICEISE NO <br />Tram ur rIA I LINE OR ITEM <br />WATER CLOSET (TOILET) <br />FEE <br />--- <br />NO. <br />--- TYPE OF EQUIPMENT <br />FEE <br />BATHTUB <br />_AIC—AARS <br />iNDLGUN <br />, <br />LAVATORY (WASH BASIN) <br />__ <br />_ <br />FORCED AIR SYSTEMS <br />SHOWER <br />' <br />_ <br />HEAT PUMP <br />_ <br />KITCHEN SINK 8 DISP <br />to <br />I <br />_ <br />IT HEATERS <br />, <br />DISHWASHER <br />_ <br />CLOTHES DRYERS <br />' <br />LAUNDRY TRAY <br />pANGEHOOD <br />' <br />CLOTHES WASHER <br />i9< <br />WATER HEATER <br />I <br />UR1:1AL <br />,'' <br />WOOD STOVE <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />, <br />DRINKING FOUNTAIN <br />; <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />_ <br />' <br />GAS FIREPLACE <br />1 <br />�-- <br />BACKFLOW PREVENTERS <br />'— <br />'• <br />_ <br />( SINK (SERVICE —BAR, ETC.) <br />; <br />GAS RANGE <br />, <br />GAS PIPING <br />r— <br />EXHAUST FAN <br />I <br />, <br />I <br />r <br />' <br />, <br />, <br />SUB TOTAL S <br />) <br />SUB TOTAL $ <br />PERMIT S <br />I <br />PERMIT S <br />—T— <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />I <br />FRONT SETBACK REAR SETBACK <br />USE ZONE <br />HEIGHT LIMITATION <br />OCCUPANCY NB C <br />GROUP <br />FIRE SPRINKLEN RF! <br />LOIAREA <br />NO OF DWELLING <br />UNITS <br />� <br />OCCUPANT LO_AD <br />REASON <br />REASON <br />SIDE SETBACK <br />VACANT SITE <br />OYES ❑ NO <br />SIZE OF BLDGRI <br />❑YES ❑NO <br />rl AN CI ICCK Numun <br />BUILDING <br />PI IIMRING <br />MECHANICAL <br />AD0111ONAI. PI AN CIIFCK <br />ONNER <br />FEE I RECEIPT NO <br />STAII' 111111 I I111lT SIIIICIIARGE <br />CITY OF EVERETT rum Ir. WORKS <br />LOCAL SALES ------ <br />TAX CODE IS 3105 TOTAL <br />