Laserfiche WebLink
APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 F 257-8810 <br />n DSMO lT!ON n COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS <br />210 5e +Lwes} Evcaei^F Moll 04,4 EUGILC'(+ <br />bN,IFR MAILAODRESS CRY Iw PHONE <br />M'cLed c 142E M R Rd TY1 1C Ad Q.• 974041" <br />TENAM MAILAODRESS 2 I D City ZIP PHONE <br />CCHOECi OR DECNfi ft n W•aelese 5.0. E•+e1L �F Moll tlA� F eae H <br />MNEN MML.HIN P5 CITY LP P 0 E <br />GEREPALCONTRACTOR MAILADDRESS City ZIP PHONE STATE LICENSE <br />V <br />ZIP <br />Ojp RP EOF WORK <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK ANO QiAE FOOAGE INRVED <br />S <br />EOCTCERSON UUP QNE I#1. <br />O <br />5 <br />6 • 7,0 I <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 15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 16.27 RCW AND 296.200 WAG. <br />IT <br />PROPOSED USE OF BUILD-4 <br />LEGAL CESMIPTgN OF PROPERTY (SHOW" BELOW OR ATTACH TWO COPMSI <br />Lot BLOCK OF <br />PARCEL TAX D. NUMBER <br />CONSTRUCTON LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />9O14AIURE DATE <br />ep35'7-2 <br />CIY BUSINESS LICE14E NIEL <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 />NC—A/HNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />i <br />UNIT HEATERS <br />I <br />KITCHEN SINK 8 OISP <br />CLOTHES DRYERS <br />I <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />i <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR. ETC.) <br />i <br />GAS PIPING <br />i <br />EXHAUSTFAN <br />i <br />i <br />I <br />SUBTOTAL S <br />j <br />SUBTOTAL S <br />I <br />PERMIT S <br />j <br />PERMIT S <br />I <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR nPPICF IIRF ONI Vn <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />RAN CHECK NUMB IT <br />FEE <br />RECEIPTNO. <br />USE ZONE <br />LOTAREA <br />VACANTSIfE <br />FEES <br />VALUATION <br />FEE <br />BUROIN3 <br />DYES Q NO <br />HEIGHTLINTATICN <br />NO.OF DAMUING <br />SIZE OF BLDNLI. <br />UNITS <br />PLUM0IM <br />=UPA <br />GRWPNK;Y <br />MY SCORES <br />OCCUPANT LOAD <br />BASEMENt <br />MECHANICAL <br />DYES ❑ NO <br />ADDITIOALPWIGIECK <br />FIRE SPRINKLER RED 0 <br />REASON <br />OTHER <br />FIRE ALARM REDD <br />REASON <br />STATE BWIDPK: SURCHARGE <br />TYPE Of L01,51 <br />PILLARS APPROVED BY <br />CITYOFEVERETT <br />FIIBLIOWORKS <br />LOCAISALES <br />DATE <br />TA%CODE IS 3106 <br />TOTAL <br />