Laserfiche WebLink
� �! <br />APPLICATION FOR CONSTRUCTION PERMIT <br />(he Everyreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />�25 -8810 <br />DEMOLITION ❑ COMBINATION � BUILDING O MECHANICAL IJ PLUMBING <br />pr 51'e�,;e�n L�v,ar; <br />'ENANi MAII <br />>N�(i'cJh�}�111 �S`�� <br />MECHANICQCqJTqACTOR M�ILADURE55 <br />PLUMBINOCONTPRCTOR MAILADDNFSS <br />C10.:50F WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR <br />TENANi IMPROVEMENT OR INTFNIOfl flEMOUEI ONLY <br />PROPOSED USE OF 0UIl01NO � <br />LEQ�LDESCRIP ONOFPROPEFTY�: <br />LOT_ BLOCK _ <br />C.ac� 1'la�� d� <br />... n � � <br />PRQIECTADDRES <br />laa <br />NO. <br />WATEfl <br />DISHWASHER <br />LAUNDHV TRI <br />CLOTHES WAI <br />URINAL <br />DRINKING FOI <br />ROOF <br />SINK ( <br />FFONTSETBACK <br />USE ZONE <br />TYPE Oi CONSi. ALlOWAOLE <br />SIIE OF BLOCi. <br />OCCUPANCYLOAO <br />REASGN FOq SPRINN�ERS <br />APPUC�TION ACC. BV <br />LOW OR ATTACH FW fl COPIES) <br />OF <br />oi�. <br />��,� <br />Cltt <br />�„� <br />c <br />cin <br />CITY <br />ur rnune <br />as4- ��so <br />zm PIIONE <br />ZIP PHONE <br />YHUfit <br />< <br />PHOI'E <br />PMONE <br />ucervse • <br />� i <br />LICENSE I <br />LILENSE I <br />everett <br />e <br />❑ SIGN <br />❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br />CON7ACT PEPWN RND PHONE N0. <br />I HEREBY CFRTIF'Y THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br />PROVISIONS OF U1WS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRAN"fIPIG QF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VtOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATF 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 />Af'PLICATION IS MAUE AND I COMPLY WITH THE Sl'ATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />SIGNATUREOFCONiF�CTOROR�UTHOPIZEO�OENT DATE <br />X�����/ �M l-i �- 9 � 1 <br />AND BUSINE55 NAME <br />MECHANICAL <br />NO. TYPE OF EOUIPN <br />A/C—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMI <br />EXHAUST <br />SUB TOTAL $ ; SUB TO' <br />PERMIT $ i PERMIT <br />TOTF.L FEE $ ' TOTAL F <br />REAq SETBACIt SIOE SETBRCK PLAN CHECK NUMBEfl FEE <br />LOTAREA VRCRNTSITE FEES VALUAT <br />❑ YES ❑ NO BUILDING <br />TYPEOlCONSIICIVAI a�P�v NaMo-xtum;UNnS — <br />GpWP PLUMBING <br />NO.OFSTORIES BASEMENT MECHANICAL <br />❑ vEs ❑ No <br />FIflESPRNKLEN5RE0D IIEIGHTLIMIT�TION OTHER <br />❑ YES ❑ NO STATE BUILDING SURCHARGE <br />STATEFNERGVSURCHARGE <br />PIAN�APPROVEUBY CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 rora� <br />--T— <br />RECEIPT NO. <br />