Laserfiche WebLink
APPLICATA FOR CONSTRUAON PERMIT <br />mP EwrpreaP <br />CITY GF <br />everett <br />BUILDING DEPARTMENT <br />259-8010 <br />DEMOLITION <br />ARCNITECTCfIMSI:NER AluADDRESS <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />BUILDING MECHAMCAL <br />EJ��N <br />ZIP PHONE <br />PLUMBING SIGN <br />PL AGCONTRACTOR M&ADa1ESS CITY ZIP PHONE LCENSEE <br />CLASS OF WONN <br />NEW ADDITION ALTERATION REPAIR DEMOLITION F1 WOODSTOVE/FRPL INSERT 1 i BUILDING RELOCATION <br />TENANT WPROYEMENT OR INTEROA REMODEL ONLY <br />cwrRAcr PRCEa WpM: <br />CONTACT PERSON AND N1a1E NO <br />OESCRBE 7;rAFCOTAOEV19LVfD <br />sE DP BwDBNo <br />AW <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERWT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 />C(05 LAW 18.27 RCW AND 296.2DD WAG. <br />y TUREOf M OR AMTHOFUED AGENT DATE nn <br />^ bT'L1T <br />LEGAL DESCRI"ONOF <br />LOT_ eLCCK a <br />PfRDIECi ApOPF55 <br />AMCANL ITYBUSINESSLCENSENOAADBUSNESSNMIE <br />PLUMBING <br />MECHAMCAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />I NO. <br />v TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—AMNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS--B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS--B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK S DISP <br />I VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE S CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />T <br />SUB TOTAL S <br />SUB TOTAL $ <br />PERMIT <br />$ <br />PERMIT S <br />TOTAL FEE <br />S. <br />TOTAL FEE $ <br />FRONT SETBACK <br />REAR SETBACK <br />610E SETBACK <br />PLAN CHECK, U BERG/ <br />EII• <br />c <br />FEE <br />RECEIPT NO . <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES h NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TMTa COSr AILBMABIE <br />Ma EONST ACTUAL <br />OtPIUO' <br />Lql <br />aopllLi WN <br />PLUMBING <br />SGEOFSLOG <br />NO OF STORIES <br />BASEMENT <br />YES 1.NO <br />MECHANICAL <br />DOCUPANLYLOAD FNESPANKLERSREOD <br />''. YES NO <br />REASON FOR BPANKLERS <br />HELM OMRANON <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APP TlON ACC BY <br />PIAHSAPPRO,TDSY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3195 <br />PUBLIC. WORKS <br />TOTAL <br />