Laserfiche WebLink
APPLICATIt,iI FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 9820' • 259-8810 <br />C7 DEMOLITION F1 COMBINATION r'1 BUILDING 'I MECHANICAL 1 PLUMBING I SIGN <br />PRO�CCTrRE -7 -- <br />OWNER NAIL ADDRESS CITY PHONE <br />�IRQ�RL,E A -vim sNoHdm rj <br />TENANT MAIL ADDRESS CPY liP PHONE �gZ�"1 V <br />/� <br />ARCHITECT OR DESIGNER MAIL ADDRESS CRY PHONE (( <br />GAKPAL CONTRACTOR MAILADDRE SS (.1 rr ,ir PHONE STATE LICENSEa \\C <br />, OYRLE Nom65 4W4106omc614 ` 1 <br />ennpccc CITY ZIP PHONE STATE LICENSE• <br />MAILADDRESS CITY ZIP <br />(�0�3lNf�N GU" �- <br />CONTBACT PRICE OF WORK <br />SYSTEM: GAS C7ELECTRIC fl <br />DESCRIBEWORK ANDSOgf OTAG11Nan <br />N�L/W�00s <br />SHEATING <br />�U SON AN PHGENOr _ 0-7J� <br />69 uN NIu,- <br />fail <br />79 170 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />&%a71 <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />OR <br />PROPOSED USE OF BUILDING <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />THE PROVISION OF ANY <br />LEGAL DESqQPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES J <br />S <br />AUTHOPITY TO VIOLATE OR CANCEL <br />LOT BLOCK DF <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />_ <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERI'ORM THE WURK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />TORS LAW 111.27 CW AND 296.200 WAC. <br />�► <br />PARCEL TAX I D. NUMBE� <br />JJJ 1 <br />LONSTRUCTIOIJ LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />X <br />SIGNATURE DATE <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />4fBATHT <br />TER CLOSET (TOILET) <br />! <br />A/C—A/HNDLG UNITS —H.P. <br />' <br />UB j <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />i <br />AVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />HOWER <br />' <br />UNIT HEATERS—B.T.U. M <br />SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />4KITCHEN <br />ISHWASHER <br />' <br />VENTILATION FANAUNDRY <br />TRAYRANGE <br />HOOD <br />LOTHES WASHER <br />WATER HEATER <br />' <br />URINAL <br />WOOD STOVE <br />MEl:4L FIREPLACE (WOOD BURNING) <br />i <br />DRINKING FOU14TAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />_; <br />CAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />' <br />— <br />' <br />GAS PIPING <br />i <br />1. <br />EXHAUST FAN <br />SUBTOTAL S <br />SUB <br />$ <br />PERMIT S <br />pERMOTAL <br />— <br />TOTALFEE $ <br />' <br />TOTALFEE $ <br />run LJrrIL.c Llac <br />FRONT SET_ ACM l <br />REAR SETBACK <br />BIDE SETBAC <br />PLAN CHECK NUMBER <br />FEE,,,( <br />�j <br />RECEIPT NO. <br />usE zoNe�7 <br />/e ' <br />LOT AREA <br />VACANT SITE <br />r1 YES IT NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />HEIGHTLLIMIT�ggTTT111pppN.1 <br />.�T <br />140. OF DWELLING <br />UNITS <br />BIZE OF BLDG/LI 1� <br />(] �I S� T <br />PLUMBING <br />L <br />l Aac-- <br />b sF G�an� <br />MECHANICAL <br />OCCUPANCY <br />NO Of STORIES <br />OCCUPANT LOAD BASEMENT <br />GROUP <br />r U •/ <br />�� <br />AYES 040 <br />' <br />1 <br />--1 T <br />I <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM RED <br />REASON <br />OTHER <br />FIRE P KLE 'D <br />REASON <br />STATE BUILDING SURCHARGE <br />) <br />Z. <br />PUBLIC WORKS <br />_ O 100 <br />rvP OF f,ON$T <br />PLANSAPJv1 e�O BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TOTAL <br />/v2172 <br />y <br />DATE 3 <br />TAX CODE iS 3105 <br />