Laserfiche WebLink
Zse-zr7+ <br />APPLICATIO* FOR CONSTRUCTAN PERMIT <br />he EYo green TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-88 , 0 <br />HEATING SYSTEM: j6GAS DIELECTRIC 0 <br />everett <br />e <br />DEMOLITION <br />❑ COMBINATION <br />BUILDING <br />i- MECHANICAL n PLUMBING SIGN <br />O/WN�ER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />In 3c S �1f�+Gv <br />/ tLtesLPT lud- <br />9S2c i 75 :S S aG J <br />[7n e n <br />TENANT <br />✓ <br />MAIL AUORESS <br />CITY <br />ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />Se-/G <br />— 06v oel'. <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE• <br />z,LY r per <br />— <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P PHONE LICENSE Y <br />CUSS OF woR. <br />ol_.AID 7 nPNAnl IT1nN <br />FII WOODSTOVE/FRPL INSERT CI BUILDING RELOCATION <br />�j/DO!%'/{ <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORA <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />�Z� r <br />J O V / <br />PROPOSED USEOF BUILDING OC .�T fr <br />Z8Y <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />7 <br />�P� �ATTA <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />SNOO/ROPE <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH O�UR-y{"--�P sI <br />Y <br />LOT C/% BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />_ <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />/ <br />INp�ieVGYd <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 />S/YIGGNAT/U99EElOF CONTRACTOR OR AUTHORIZEDAGENT DATE <br />PROJECT ADDRESS <br />APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <br />MBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EOUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNOLG UNITS—H.P. <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />UNIT HEATERS—B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />SHO_WFR <br />VENTILATION FAN <br />' <br />KITCHEN SINK & DISP <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />'MWATERHEATERATERCLOTHES <br />WASHEROVEURINAL <br />EPLACE & <br />INSERTFLOOR <br />DRINKING FOUNTAINE <br />DRAINPBACKFLOW <br />IL <br />PREVENTERS <br />GROOF <br />DRAINS—RAINLEADERS <br />FANSINK <br />(SERVICE —BAR, ETC.) <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />FOR OFFIGt: USt <br />FRONTS�;K <br />ONE <br />R-Z <br />UNLT: <br />REAR SETBACK <br />lOT AREA <br />SIDE SETBACK <br />SITE <br />HECKNUIJBER I FEE <br />aUriVACANT <br />EES <br />VALUATIONFEE <br />RECEIPT NO <br />!BUILDIN!G <br />/ I o0i <br />TYPPEOF LCONTS OWABLE <br />TY�F CONST. TL'AL <br />aGpPApCr <br />Na orPMwxaU"'SIZE <br />AL <br />OFQBLDG.< <br />NO. OF STORIES <br />BAxSEEMENT <br />ADDITIONAL PLAN CHECK <br />' <br />OCCUPANCY LOAD FIRE SPRNKLERS REO'U HEIGHT LIMITATION <br />N () <br />REASON FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />l iso <br />PUBLIC WORKS <br />INTAKE BY <br />PLANS A PROVED I <br />/ <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />