Laserfiche WebLink
APPLICATIOA FOR CONSTRUCT �ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f7 DEMOLITION �l COMBINATION �I BUILDING Aq MECHANICAL f� pLUMBING fl SIGN <br />PROJECTADDRESS p16nS CVERG0.CC� IA/�`( S�ITE lr <br />OWNER MAILADDPESS CITY ZIP <br />f`HONE <br />GENERALGONipACTOR MAILAODRESS Qtt ZIP PIIONE Si4TELILENSE• <br />�R1CKSa.�M�WT Z.OZ�I CCDRfI Va�iPt AD L`Iaav000 98�36 775-1i4'] Fal.•1C•klx 21tL)— <br />MECHANICAL CONTRACTOR MAIL AOORE55 CIN ZIP PIIONE STATG LICENSE � <br />PLUMBINGCONTRACTOR MAIL�O�RE55 CIN qp P110NE ST�T[LICENSE� <br />� 7 Q "iCW <br />DESCRIBE WORKAND SOUARE FOOTAGE INVOLVEO <br />TYP[ T kaTcNL� EXHp� <br />PROPOSED USE OF BUILDING <br />RC5'[A� 0.A �T <br />IEGRL DESLRIPTION OF PROPERTV (SMOWN BELOW OR ATfACM <br />LOT BLOCK OF <br />PARCEL7aXI.0.NUMBER <br />CONSTRUCTIONLOPNLENDER.AUDRESS.TELEPNONENUMBF.R <br />PLUMBING <br />NO. TYPE OF FIxTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEA <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR. ETC.) <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE 5 <br />FOR OFFICE USE ONLY: <br />FRONT SETPACK REAR SETBACK SIDE SETBRCK <br />USE ZOtlE <br />HEIGIIT LIMITATION <br />OGCUPANCY NO Ot51 <br />GROUP <br />FIPE ALARM RE00 <br />FIRE SPRINNIER RF.O'D <br />LOiAFEA <br />N0. OF DP/ELLING <br />UNIiS <br />OCCUPANTL040 <br />PI�NS <br />oaTE I � <br />HEATING SYSTEM: f l GAS rl ELECTRIC I� <br />CMIC�.L�EREIIINCLC�10JN0. � �S — .']��� <br />I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE THUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORL�INANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHEF 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 LOCA� LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />�L�13�q,__5 _ <br />SIGNATURE � DA <br />CITV BOSMESS LICENSE NO. <br />NO. TYPE OF EOUIPMENT FEE <br />eic _ nn.�urn r. i �uirc _ u o <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. <br />HEAT PUMP <br />UNIT HEATERS — B.T.U. M <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAI FIREPLACE ( <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL S <br />TOTAL FEE S <br />PLAN CIIECN NUM�ER I FEF � f1ECEIPT N0. <br />VACANT SITE FEES <br />fIVES fi NO pWIDING <br />SRE OF BLOGRI <br />PLUN�ING <br />BASEMENT MECNaNICnL <br />f1YE5 I�1 ND <br />ADDI110NAL PL4N G��ECK <br />OTI{ER <br />ST�TE OWlOINf, SIIRCHnRGE <br />°Y CITY OF EVERETT �uonc wonKs <br />� LOCAL SALES <br />,i-`jJ TAX CODE IS 3105 TOTAL <br />