Laserfiche WebLink
APPLIGAThwd FOR CONSTiRUC1.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 Omcr�o <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING CI MECHANICAL ❑ PLUMBING N SIGN <br />(PROJECT ADDRESS <br />sul"G 106 5'uF'K rr ww <br />MAILADDRESS <br />ZIP PHONE <br />0c^15r&ur-•T'loN <br />o97s <br />also IArC <br />P.O.60A 97s <br />L-�e,lnwood qs-.20?- <br />TENANT <br />MAILADDRESS <br />CITY <br />ZIP PHONI <br />5•LEBrcounrizy <br />503-5•w• <br />EVE/2Err^AA-L.wNy EUI_rZE'rrLVW <br />5' • gzo3 <br />ARCHITECTORDESIGNER <br />MAIL AOORESS <br />CITY <br />ZIP PHONE <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE II <br />BEI2eu//EoNca, <br />P0-66x611(eR Gyniwaocd <br />(,..rq. <br />99'696 77v'8835 <br />8Ck0Y Nc071•CM <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSER <br />PLUMBING CONTRACTOR MAILADDRESS CITY ZIP PHONE STATE LICENSE# <br />CONTRACT PRICE OF WORK <br />00 °= /N57-(4LL c U5T0n\epts -T I&A/ <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />//VST{9LL /1-L i/M1eyl4TE D <br />CONTACT PERSON AND PHONE NO. <br />G-QE7&( FuL-T-G t I �7 Fr$3S <br />L�TTE2S OA/ AVCZT14 wESr Y3t_Db - <br />/_��/� <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 L:'NS 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 LAW 18.27 RCW AND 296,200 WAC. <br />X AIL �� <br />PROPOSED USEOF BUILDING.DING �t7rn Es s S/�L ES' <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />SEE E4TI-Iq cli ff-0 <br />PARCEL TAX I.D. NUMBER <br />sE E -r-rtqc 14f-P <br />CJNSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />- <br />SIGNATURE O iy 7 / DATE <br />Y/ <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C—A/HNDLGUNITS —H.P. <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS—B.T.U. M <br />' <br />KITCHEN SINK & DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />' <br />URINAL <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />' <br />' <br />GAS PIPING <br />i <br />EXHAUST FAN <br />1 <br />' <br />I <br />' <br />SUB TOTAL S <br />I ' <br />SUB TOTAL $ <br />' <br />' <br />PERMIT $ <br />PERMIT S <br />I <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />cnp FIFFICF IICF CANT V. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />OYES ❑ NO <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDGR.I. <br />' <br />UNITS <br />PLUMBING <br />OCCUPANCY NO. OF STORIES <br />OCCUPANTLOAD BASEMENT <br />MECHANICAL <br />GROUP <br />I <br />L7YES ❑ NO <br />ADDITIONAL PLAN CI?CK <br />FIRE ALARM RED <br />REASON <br />OTHER <br />i <br />I <br />FIRE SPRINKLER REGD <br />REASON <br />' <br />STATE BUILDING SURCHARGE <br />I <br />TYPE OF CONST <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />