Laserfiche WebLink
APPLICATIG_J FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET . EVERETT, WA 98201 •259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />MAIL ADDRESS <br />PHONE <br />ARCHITECT OR DESIGNER MAP ADDRESS CITY ZIP PHONE <br />CITY <br />MAIL ADDRESS <br />LICENSE <br />PHONE STATE LICENSE <br />PLUMPING CONTRACTOR MAIL ADORE SS CITY ZIP PHONE STATE LICENSE, <br />CONTRACT PRICF OF WORN <br />HEATING SYSTEM: ❑GAS El ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />01 HER S rA(E 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 18.27I -,W 96.200 WAC. <br />/n �/ <br />X (j ��/ <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPER" (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAX 1. D.PUMBER <br />a %q/ 00- E'Oo(n <br />COT'STRUCTI NLOAN LENDER. ADDRESS, TF LEPHONE NUMBER <br />SIG IATURE DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C —A/HNDLG UNITS <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />_ <br />SHOWER <br />' <br />UNIT HEATERS <br />; <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />—r— <br />DISHWAS-HE R <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />�— <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />� <br />I <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />$ <br />PERMIT $ <br />_PERMIT <br />TOTAL FEE $ <br />TOTAL FEE $ <br />Ono ncclf`r IICC nml V. <br />FRONT SFTRACK <br />REAR SFTBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEF <br />RECEIPL NO <br />I3�� <br />LSE ZONE <br />IOF AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />JJ <br />i(� <br />- <br />DYES ❑ NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGRI <br />UN 11S <br />PLUMBING <br />T- <br />OCCUPANCY NO Df SIDRILS <br />OCCUPANT LOAD BASEMENT <br />MECHANICAL <br />' <br />GROUP <br />_ <br />❑YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />FIRE SPRINKLER REO'D <br />REASON <br />OTHER <br />FIRE ALARM RED <br />REASON <br />STATE BUILDING SURCHARGE <br />w <br />PIIBI IC WORKS <br />TYPE OF f.ONSi <br />P. APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />OnrE <br />