Laserfiche WebLink
ym H <br />tYHCA <br />�tHHtH��70tl <br />�VJ N <br />z <br />Hoo <br />pHC <br />�4 g <br />LA Q <br />1 <br />�H <br />z <br />HH <br />gy H <br />a l7 O <br />1-3[Ci3 <br />H O to <br />I <br />APPLICATIOrd FOR CONSTRUCT hON PERMIT everett <br />the Evergreen TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett HEATING <br />BUILDING DEPARTMENT SYSTEM: GAS ❑ELECTRIC ❑ _ <br />259.8810 <br />❑ DEMOLITION COMBINATION BUILDING _ ECHIANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS 5,13, CITY ZIP PHONE <br />TFNANT /��I <br />` •lV(7VPIA= <br />AUIL pO0RE55 <br />/Sl Z 5,E <br />Met k lN1 <br />CITY <br />, y�12d/? <br />nr/� <br />rnvnc <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />A n MU=cAI�yicm-L <br />MAILADDRESS <br />sus <br />]3O A( <br />l ~ <br />CITY <br />644/ y 99Z6 <br />ZIP <br />PHONE <br />(, 3z?J- — i� <br />LICENSE <br />4PME( L2I A <br />MECHANICAL CON"TRAACT� AWL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />PLUMB}NG CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSEI <br />CLASS OF WOFI <br />:I� <br />D=DAID <br />nFAAnI ITInN <br />" V/OODSTOVFJFRPL INSERT <br />C BUILDING RELOCATION <br />2 <br />CONTACT PE NA HOyCyO- 7 <br />/����C/y, <br />CONTRACT PRICE OF WORN 2 O OO <br />" <br />DESCRIBE WORK AND SQUARE FOOTAGEINVOLVED <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED l-HIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOWOR ATTACH FOUR COPIES) <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 298.200 WAC. qq <br />AGENT DA !\/;6 /ICJ/ <br />SIGNATURE OF CO CC�TOORRROOR�/.-AAUUT/�HORIZED <br />X 1 <br />L������� <br />PRCCyJ9F T,�A�DDD-�RESS tqV r <br />1' <br />APPIICANTSCITV BUBINESB LICENSENO. AIIDBUBiNE55NAME <br />TY <br />/� S,r, pVEfejF-7 rnALL <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />77 <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />ANC—A/HNDLG UNITS—H.P. <br />. T— <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 3 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />i <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />E%ROUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />I <br />' <br />SI'l TOTAL $ <br />SUB TOTAL <br />PERMIT $ <br />PERMIT $ <br />/,'�✓ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />Ivn v <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEL <br />RECEIPT NO. <br />FRONT SETBACK <br />/m7 <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />, <br />TYPE OF CONTS ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />=UNUK" <br />NBa PMUING UNITS <br />GRWP <br />PLUMBING <br />i <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />— <br />OCCUPANC.LOAD FIRE SPRNKLERR REOD HEIGHT IIMITpTION <br />I <br />OTHER <br />REASON FOR SPRINKLERS <br />i <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PUNS APPROVED BY <br />CITY OF EVEflETT <br />PUBLIC WORKS <br />i <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />; <br />