Laserfiche WebLink
�►PPLICAT11,n1 �OR CONS'�RUCI .ON PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259•8810 <br /> ❑ DEMOLITION f� COMBINATION I�l BUILDING rl MECHANICAL f� PLUMBING rl SIGN <br /> PROJECT ADDRESS \/ /aO 3 S� �—V ���� � <br /> i� <br /> rMONe <br /> Q� MAILADURESS iCITV / ZIP ;G :�''�/ ��}� ^ , n� ��n <br /> �`�' I I � {�J/D � PHONE i,v <br /> TEN4 <br /> M . IlDRE55 ��T� Z�P <br /> �/ � � �� CIC ZIP PHONE <br /> AR HITECT OR DESIGNEFi MAIL AD�(iE55 <br /> ���, Z�p PHONE STATELICENSE� <br /> GENEFALCONTRACTOA MFILAODRESS <br /> M CHf�JC LCONiRACTOR MAILADDRE55 � CITY 21P � PNONE STATEIICENSE� <br /> � PAr�s�°K('� l3ox �Z6� / -af /r,waa�ro�. CtJ�y-gko �f t�-6 &ys3�c(�,�4��0 <br /> LU BIN6CONTRFCiOR MAILADDRE55 <br /> ¢ pN 21P � PHONE STHTE IICENSE� <br /> e �'� - <br /> CQYNjRACTAPRfI'C�EyO�F WORK HEATING SYSTENI: ❑ GAS ❑ ELECTRIC ❑ <br /> "' /(/////�/ ` <br /> 6E5 RIB' IORKAND SOUARE FOOThGE INVOLVEO GONTnCT PER ON ANO PHONE NO. � /� �L ^_ <br /> L <br /> N �� �� - -- <br /> I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION HNU KNOW THE SAME l�0 BE TRUE AND CORFECT.ALL <br /> PnoaoSeouseoFeui�oir+c PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALDESCRIPTIONOFPROPE9T1'(SHOWNBELO` �ATfACHTWOCOPIE51 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMF. TO GIVE <br /> �or e�ocK oF 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 T S PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATI IS MADE A I COMPLY WITH THE STATE <br /> CONTRA S LAW .27 AND 296200 WAC. <br /> PpRCELTAXI.D.NUMBEfl <br /> / <br /> CONSTRl1CT10N LOPN�EN�ER.AD�FESS,TCLEPHONE NUMOER X / DA - — <br /> I <br /> CITY SWESSIICENSEP . <br /> PLUMBING ME HANICAL <br /> FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM ' <br /> WATERCLOSE'. (TOILET) � A/C—AIHNDLGUNITS—H.P. <br /> � FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> BATHTUB ' � <br /> LAVATORY(N ASH BASIN) � HEAT PUIdP <br /> � UNIT HEATERS—B.T.I�. M � <br /> SHOWER i <br /> KITCHEN SINK d DISP ; CLOTHES DRYERS <br /> � VENTILATION FAN � <br /> DISHWASHER ' <br /> — � RANGEHOOD ' <br /> !AUNDRYTRAY � � <br /> CLOTHES WASHER � WATER HEATER <br /> � WOOD STOVE � <br /> URINAL ' <br /> DRINKING FOUNTAIN ' <br /> METAL FIREPLACE(WOOD BUR.�ING) � <br /> � � FIREPLACE INSERT(WOOD BURNING) ' <br /> FLOOR DRAI^! ' <br /> GAS FIREPLACE ' <br /> BACKFLOW PREVENTERS � , <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE <br /> � GAS PIPING � <br /> � � <br /> EXHAUSTFAN ' <br /> � � <br /> � , <br /> � ' <br /> � , <br /> SUB TOTAL 5 ; SUB TOTAL S � � <br /> PEHMIT S /:� ' <br /> — FERMIT S ' TOTAL FEE S 'S ' � <br /> — TOTAL Pf°E 3 ' <br /> FOR OFFICE USE ONLY: ReceivrNo. <br /> FRONi SEiBACK REAR SET�ACK SI�E SETBACK PV�N GHECK N�ER PEE <br /> Grl FEE <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION <br /> i <br /> i <br /> IlYES �l NO BN��ING .�_ <br /> i <br /> HEIGHT LIMITATION NO.OF DWELLING SRE OF BLOG/TI. i <br /> UN1T5 FLUM0ING �� <br /> i <br /> OCCUPANCY NO OFSi0RIE5 OCCUPANTLOAO BASEMENT MECHPNICAL � <br /> GROUP � <br /> ❑YES fl NO � <br /> AODITIONPI PLAN CHECK i <br /> FIREALARMREO'0 REASON � <br /> OTHER � <br /> i <br /> FIRE SPRINKLEl1 REOD REASON STATE BUIIDING SURCMARGE � <br /> i <br /> 1YPEOFCONST PIANSAPPROVED�Y CITYOFEVERET� PUBLICWORKS � <br /> �JV� LOCAL SALES 707AL � <br /> OATE l ' � TAX CODE IS 3105 <br /> � <br />