Laserfiche WebLink
APPLICATIOA FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 0259-8810 <br />❑ DEMOLITION ([ COMBINATION ❑ WILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN: <br />PROJECT ADDRESS: (7/. ) /Yi- // i/ z/ <br />--" rnunt STATE LICENSE r <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br />_ CTRACT PRICE qF V'm0 <br />IfQ <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />i r . 3loO xja� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROPOSEOUSE BUI`DING� <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <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 LAW 16.27 RCW AND 296.200 WAC. <br />X <br />PARCEL TAK I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />' <br />SIGNATURE DATE CJ <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS <br />BATHTUB <br />; <br />1 <br />FORCED AIR S'/STEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />' <br />SHOWER <br />UNIT HEATERS <br />� <br />, <br />KITCHEN SINK R DISP <br />) <br />CLOTHES DRYERS <br />DISHWASHER <br />, <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />I <br />CLOTHES WASHER <br />, <br />WOOD STOVE <br />, <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />; <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />, <br />GAS FIREPLACE <br />, <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />SINK ERVICE-BAR.ETC.)1'7.),,!) <br />, <br />GAS PIPING <br />EXHAUST FAN <br />r <br />, <br />, <br />, <br />, <br />' <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT S <br />, <br />PERMIT S <br />, <br />TOTAL FEE Si <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />USEZONE <br />LOTAREA <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />UNITS <br />OCCUPANCY <br />HD a PORI, <br />OCCUPANT <br />^LOAD <br />l �� <br />FIRE SPRINKLER REGO <br />A,,SS(Oy�Nyyyy�J���jjTT�A���� <br />[lnEtw/lw� <br />FIRE AIARILI REO'D <br />ASON <br />`lw% <br />TYPE OF CONST <br />PLANS APPROVED BI <br />�4 <br />�q <br />�N <br />n <br />DATE ( Y <br />