Laserfiche WebLink
APPLICATIOd FOR CONSTRUCTrON PERMIT <br />CITY OF EVEREI T • BUILDING DIVISION0;:77 <br />'1200 CEDAR STREET • EVERETT, NIA 98201 • 259-8810 <br />1-1 DEMOLITION I I COMBINATION % BUILDING I-1 MECHANICAL I PLUMBING i I SIGN <br />PROJECT ADDRESS <br />OWNER <br />MAIL ADDRESS <br />CITY <br />71P <br />R.A.. <br />C�� LE aE�7T 351 C45—W EVS&EiT /Alfa 2E7 - `397 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />M1iCEG9Afi �lV-H <br />ECT5 <br />E LAO 17 <br />N9- .259 -3!6/ <br />BEN RALCONTRACTOR <br />MAILADvnEEss <br />CITY <br />ZIP PHONE STATE LICENSE) <br />/�j��T <br />��� <br />MECHA IOALCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE STATE LICENSED <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE II <br />CONTR CYT PRICE OF WORK <br />HEATING SYSTEM: P(GAS n ELECTRIC rl <br />DESCRIBE WO K AND SOUARE FOOTAGE INVOLVED /A-}� J�? <br />-ADD) >+ 6UAL4 >� -A 7& <br />CONTACT PERSON AND PHONE NO. <br />G - <br />1 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 APECIFIED 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 />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 19.27 RCW AND 296.200 WAC. <br />X a/A.I� e!!�L gI-lqjSIGNATURE <br />PROPOSED USE OF BUILDING <br />,'a7l/c�ACf/ J�`D <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK Or <br />/ <br />PARCELTA%J.D. NUMBER <br />CONCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />STRU <br />DATE YYY <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL _ <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER GL06ET (TOILET) <br />A/C —AMNDLG UNITS —H.P. <br />�— <br />' <br />_ <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />_ <br />UNIT UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />i <br />CLOTHES WASHER <br />�— <br />WATER HEATER <br />_ <br />URINAL <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />_ <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />_ <br />GAS PIPING <br />I <br />EXHAUST FAN <br />T <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />PERMIT $ <br />TOTAL FEE $ <br />TOTALFEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SFTOACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />PEE <br />RECEIPT NO. <br />$ 1�0102 <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FE <br />BUILDING <br />TIYES T1 NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGRI <br />UNITS <br />110 G f! <br />N r✓ <br />PLUMBING <br />' <br />T <br />OCCUPANCY NO OF STORIES <br />OCCUPANTLOAD BASE <br />MECHANICAL <br />GROUP <br />I <br />AYES fl NO <br />) <br />ADDIOONAL PLAN CHECK <br />FIRE ALARM RED D <br />REASON <br />) <br />OTHER <br />) <br />FIRE SPRINKLER RED <br />EASCN <br />) <br />STATE BUILDING SURCHARGE <br />I <br />� <br />TYPE OF f,ONST <br />PLANS APeaoveo BY <br />TY OF EVERETT <br />PUBLIC, WORKS <br />' <br />•VVI� <br />LOCAL SALES <br />;TAX <br />I� <br />' <br />DATE (0 <br />CODE IS 3106 <br />TOTAL <br />L� <br />