Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />APPLICA"AON FOR CONSTRG.:TION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />OWNER MAILADDRESS CITY ZIP PHONE <br />MECHANICAL CONTRACTOR MAILADDRESS CITY ZIP PHONE LICENSE- <br />-LICENSE LICENSE• <br />PLUMBING CONTRACTOR MAIL ADDREGS LITY 21P i'l1ONE <br />❑ RIIILDING RELOCATION <br />AVunIRIVn a nu �nn��..�. .� <br />..�. ..... _ __...__..._.. <br />— <br />CONTACT POISON AND PHONE NO. <br />IENANT IMPROVEMENT ONTE�RIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK }" A_ <br />DESCRIBE WORN AND SOUARE FOO V GE INVOLVED <br />-jrol) Soy 'n� <br />— <br />PROPOSED USE OF BUILDIN3 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />FC O J <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />THIS TYPE OF WORK WILL BE COMPLETED WITH <br />LE(Nl DESCRIPTION OiPOPERTY(SHOWN BELOW OR ATTAUK fOPA COPIES( <br />ORDINANCES GOVERNING <br />WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING UFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLAi E OR CANCEL THE PROVISIONS OF <br />OF <br />ANYOTHER STATE OR LOCAL LAWREGULATING CONSTRUCTION ORTHE PER• <br />LOT_.—_ BLOCK <br />FORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />— <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAG <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE /F <br />PROJECT ADDRESS <br />APPII NTS CITY BUSiNN�55 LICENSE NO. N RUSINE55 NAME <br />^ <br />Y <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C -- A'ANDLG UNITS — H.P. <br />FORCED AIR SYSTEMS— B.T.U. M EA <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />_ <br />SHOWER <br />CLOTHES DRYERS _— <br />KITCHEN SINK& DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUSTFAN <br />SINK(SERVICE—BAR, ETC.) <br />SUBTOTAL <br />$ <br />SUBTOTAL _ $ <br />PERMIT <br />$ <br />PERMIT S <br />TOTAL FEE <br />T <br />TOTAL FEE s <br />FRONTSETBACK <br />REAP SETBACK <br />SIDESETBACK <br />PUN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />l <br />CI YES ❑ NO <br />BUILDING <br />_ <br />TYPE OF COJST. <br />OCCUPANCY GROUP <br />NO. OF DWELLINGUNITS <br />ALLOWABLVACTUAL <br />PLUMBING <br />CIZE OF BLDO <br />NO. OF STORIES <br />SSMi. <br />OCC LOAD <br />❑Y <br />MECHANICAL <br />OTHER <br />❑ N <br />HEIGHT LIMITATION <br />STATE BUILDING SURCHARGE <br />FIRE SPRINKLERS REowpEo ❑ YE7 o NO <br />__ <br />STATE ENERGY SURCHARGE <br />PUBLICWORKS <br />APPLICATION ACC, BY PLANS APPR. BY <br />TOTAL <br />