Laserfiche WebLink
APPLICATI�,�I FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISIUN <br />3200 CEDAR STREET • EVERETf, WA 98201 • 259-8810 <br />❑ DEMOLITION ❑ COMBINATION Cl BUILDING ❑ MECHANICAL �PLUMBING ❑ SIGN <br />PROJECT ADDRESS � ��y �/ `v� <br />1�� 5 � <br />Q4�JER � � MAILAOORESS CITV . i 21P PHONE <br />PLUMBING CONTRACTOR <br />�.-/ — V / ` <br />GONTRACT PRICE OF WOR.( <br />DESCRIBE WORK AND�pUARE <br />2� S <br />PROPOSED USE OF BUIL <br />� � <br />LEGAL DESCRII`TION OF PROPF <br />LOT BLOCH <br />MAILAOURE55 <br />FOOTAGEINVOlVEO <br />� <br />PARCELTq%I.D.NUMBER <br />CONSTRUCTION LORN LENU'eR, ADDflE55, TELEPNONE NUN.BER <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BA'iHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SEFIVICE — BAR, ETC.) <br />POR OFFICE I;SE ONLY: <br />FRONT SETBACK REAR SETBACK <br />USEZONE <br />HEIGMT LIMITATION <br />SUB TOTAL S <br />PERMIT ^� <br />TOTAL FEE $ <br />LOTAAEA <br />NO.OF DWELLING <br />UNITS <br />OFCONSi. I PIANSAPPFOVE�BY <br />� <br />� <br />CRY <br />cirv <br />�jr�2/ lS '- 5�,��7�,5� <br />ZIP PHONE <br />I%% �1Ry/W�� <br />ZIP /%9HONE <br />U <br />ZIP PIIONE STATE LICENSE / <br />ZIP PHONE STATE LICENSE I <br />��TY Z�P PHONE STAiE LICENSE Y <br />� HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑_ <br />CONTACT PEFSON AND PHONE NO. <br />I HERFBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORqECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS TYPE OF <br />WORK WILI 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 AUTHOFIZED BY THE <br />OWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATI N IS MADE AND I COMPLY WITH THE STATE <br />CONT ORS LAW 1827 RCyVAND 296200 WAC. � <br />CIN BUSINE55 LICENSE NO. <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />A/C — A/HNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUST FAN <br />SIDE SETBACK PLAN CH[C! NUy9E97 <br />�(C)5� <br />VFCANT SITE FEES <br />❑YES ❑ NO OUILDING <br />SIZE Of BLW?.I. <br />PLUM9ING <br />BASEMENi MECHANIC�I <br />❑YES C7 NO <br />Ap01ilONFL PLl�N CHECK <br />OTH�R <br />STATE BUILOMG SUACHARGE <br />CITY OF EVERETT rueucwoaKs <br />LOCAL SALES <br />TAX CODE IS 3105 70TAL <br />PERMIT $ <br />TOTALFEE S <br />fEE I RECEIPTNO. <br />FEE <br />