Laserfiche WebLink
APPLIC� rION FOR CONSTRaTION <br />PERMIT <br />the Entgtoon <br />CITY OF everett <br />everett e <br />BUILDING DEPARTMENT <br />259.8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNEp <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ZS"fk ('_.Tc„e <br />r' iu�� ?�nrrc <br />C <br />c eij fgk r <br />t�A �i&o8 <br />M-07.27 <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE I I. <br />Z, <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />a <br />k <br />GENEMLC04MACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE• <br />v► <br />1,L <br />9kagsec, 14 Sa R <br />Mi <br />It <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY LP PHONE LICENSE <br />IA AI <br />I-1 u fl .nmTlnM *Se AI TFRATInN ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />TENANT IMPROVEMENT OR INTERI R REMODEL ONLY �- <br />CONTRACT PRICE OF WORK w QZ O7J9 <br />CONTACT PERSON AND PHONE NO. <br />fi 3 • �U�'2 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />AAA Wkoo"-\ cwA&-ol4Ar#R.,ot+E. <br />PR5F.0r8ED USE OLF BUILDING Gt <br />ylvt7� trT71"�ti Rlzil,0Cf__ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WH ETHER SPECIFIED H EREIN OR NOT. THE GRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF. -HE PER- <br />FORMANCE OF CONSTRU :TION. THAT 1 AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFO74 THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE b.ATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAG <br />SIGNATURE OF CONTnACTOR OR AUTHOR`CD AGENT DATE <br />APP ANTS CITY BUSINESS LICEtIE NO. ANJpBJSINtSS "N�AME <br />IfE/QsSAGEL CaA1S , CO, <br />LEGAL DEBGIIPIION OF PROPER IBHOWN BELOW OR ATTACH FOUR COPIE51 <br />C ���� <br />LOT BLOCK OF <br />Cs— & <br />FRDJECTADDRES8 <br />PLUMBING <br />CHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />— <br />A/C - A/HNDLG UNITS -H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS- aT.U. M EA <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS -BTU. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK& DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS- RAINLEADERS <br />EXHAUST FAN <br />SINK(SERVICE- BAR. ETC) <br />SUBTOTAL $ <br />SUBTOTAL $ <br />PERMIT & <br />PERMIT $ <br />TOTAL FEE & <br />TOTAL FEE S <br />FRONT SETBACI(O4 <br />REABACK I� /�, <br />I to �, <br />I co <br />PU NECK NUMBER Z7 <br />FEE 3 <br />RECEIPT NO. <br />USEZONE <br />LOTAREA p <br />/©y(7 <br />VACANT SITE <br />OYES MNO <br />/ <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE OF CONST, <br />ALL ABLE/ TU <br />OCCUPANCY GROUP <br />17�- <br />NO.OF DWELLING UNITS <br />/ <br />PLUMBING <br />SIZE OF BlEUI,L <br />�_ / <br />/J <br />NO.OFSTORIES <br />BSMT. <br />OY <br />❑ N <br />OCC LOAD <br />MECHANICAL <br />OTHER <br />_ <br />FIRE SPRINKLERS REQUIRED OYES V NO <br />HEIGHT LIMITATION <br />STATE SUILC'ING SURCHARGE <br />APPLICATION ACC, BY PLANS APPR. BY <br />STATE ENERGY SURCHARGE <br />PUBLICWORKS <br />TOTAL <br />0 <br />