Laserfiche WebLink
everett <br />APPLICATIO.. FOR CONSTRUCT6 (ERMIT . , <br />TO BE COMPLETED IN INK —PLEASE PRINT �/ L,' C <br />the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-BB10 <br />DEMOLITION COMBINATION <br />OWNER MAIL ADDRESS <br />Go�7r �t-•.��-Slc_-,aS <br />GENERAL CONTRACTOR MAIL ADDRESS <br />HEATING SYSTEM: ❑ GAS <br />❑ ELECTRIC <br />U <br />LI: <br />PuLiic 1'! ''11 <br />BUILDING <br />MECHANICAL <br />PLUMBIISGLS <br />ZIP <br />PHONE <br />1 <br />Tn Q F► <br />CRY <br />ZIP <br />PHONE <br />CITY <br />ZIP <br />PHONE <br />Pt i�F 1 <br />�1`t3cX� <br />1a� <br />CITY <br />21P <br />PHONE <br />PHONE <br />LICENSE A <br />CITY <br />ZIP <br />........... <br />rr <br />Jd SIGN <br />CLASS OF WORK REPAIR DEMOLITION WOODSTOVE/FRPL INSERT S. BUILDING RELOCATION <br />iONEW - ADDITION ALTERATION ERATION <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUA.RE'F{�OOTA EE INVOLVED <br />`- L1 \ <br />PROPOSED USE OF BUILDING �— �y ��V L�> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />IJu -� "t1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PRO E TY (SHOWN sal BELOW OR ATTACH FOURCOPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />BLOCK of NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT 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 296.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />�-13-�t3 <br />PROJECT ADDRESS q�ZG� APPLICANTS CITY BUSINESS LICENSE NO. AND BUSINESS NAME <br />;INK & <br />TER <br />TRAY <br />FOUNTAIN <br />ROOF <br />TOTAL $ <br />MIT $ <br />4L FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />NEAR S TBACI // <br />USE ZONj E I� <br />LOT AREA <br />TYPE Of CONTS ALLOWABI[ <br />TYPE OF LONSi ACIUAI <br />Er i. OF BLDG. <br />NO. OF STORIES <br />OCCUPANCYLOAD d <br />FIRE SPRNKLERS REDO <br />REASON FOR SPRINKLERS <br />PLAITS APPROVED BY <br />INTAKE BY <br />'I ` <br />NO. rT M yr .....,...._ <br />A)C-AIHNDLG UNITS-H.P. <br />FORCED AIR SYSTEM M <br />UNIT NEATENS-B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />'I FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />PERMIT <br />$ <br />D <br />ypF551BACK <br />PLAN' -PECK NUMBER FEE <br />d <br />�� // <br />FLEES VALUATION <br />FEE <br />VACANT SITE <br />I <br />I - <br />BUILDING <br />OCCUPANCY No Or owBinG UNVS <br />; <br />GROUP <br />PLUMBING <br />---'— <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />HEIGHT UMRATION <br />OTHFR <br />-- ;T <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT <br />PUBLIC WORKS — <br />' OCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />