Laserfiche WebLink
APWLlCATI(�`�"1 FOR CONSTRUC'Y'"�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—FLFASE PRINT <br />BUILDING DEPARTMENT HEATING SYS7EM: ❑ GAS �ELECTRIC U l <br />259-8810 <br />❑ DEMOLITION CQMBINpTl01� '_! R�1ILDING f� MECHANICAL pLUMBING __; SIGN <br />OWhER IAAILAODFESS CITV 21P PHOryE f}M ��'JI� <br />� . ; %`�'�T�A/ �23�-SG t�Si S (C/�r/F•C� � i l�'i�I9��G � ��-7G�i �S�-LY4Z <br />TENANT MAILADOFESS LITY ZIP i PHONE <br />FFCHITEQOFDESIGNEP MAILADDRESSLyO/L�'j fJES. <br />S���An.R �`Nn,e�N i/�9 M��;���.. r <br />GENERALCONiRACTOR MAILqODRESS <br />(� U//�1 E /� � <br />MEGMANICFLCONTqqCiOF MAILRCOAESS <br />PLlIM31NGCONTRACTOR MAILADDRE55 <br />CONiRNGT PRICS OF WORH <br />! 1 I , � - <br />��"/'._�"'-"—_ <br />r <br />.� OESCPIBE WORK nvO 50UARE FOOTpGE INVOLVED <br />� �.�/��L v_-xis,��-R t!/Jv��; 15i6Gp.= <br />�C�,..�nJ��,E'= _S�0 SF ,aP%�� <br />1 "�nl -�/' �c���4 cr „e.v,r I�q�-�. �-:�� <br />PROPOSEOUSEOfBI11WING �:r+� <br />C(TV <br />QT� <br />LEGAL OES:,RiPiION OF PFOPEFT/Y� �pS/HO��W N hBLOJN'OR ATTAGH'. WO GOPIES) <br />LOTS �� � BLOCK J1SL_ OF �LHL �f �E%F-T� <br />I2llLA C[O,PDI/L"� 70 ?N6 i�<�_�H<G.F'OF �F'LCD�1pEt <br />PARCELTAXID.NUM9Efi <br />��69 �'U _�r��- /��'C�2 <br />CONSTPUCTION LOAN LENOER. A�OFESS, TELEPHONE NUNPER <br />PLUMBING <br />0. TYPF OF <br />LAVATORY�WASH BA; <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING fOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PPEVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.1 <br />FEE <br />SUB TOTAL S �/n ; <br />PERMIT $ �—' <br />TOTAL FEE 5 , <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REARSETBACK <br />i / <br />/ �i -� ;J � 9'%�(=�r. <br />USEZONE �LOTPP[F � <br />�- <br />TVPEO�CONST. NOAFSTOfilES <br />SIZE OF 9lDG FIfiE SPRiNKLENS FEO'0 <br />/?LL /v� <br />S/� � IL( �(i �Ci � <br />REr150N <br />INTANE�Y PLAN$APPROVEDBY <br />��� A� <br />oaTe � - 17 - S3 <br />PHO�E <br />ZIP <br />STATE UCENSE Y <br />[iN PHONE STATE LICENSE • <br />PHONE STATE UCENSE � <br />IE NO. � �S� _�� <br />rt�ni i - -za <br />N/7� 353 —7� �/ / <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI� <br />APPLICATIOtJ AND KNOW THE SAME TO BE TRUE AND CORRECT. AL. <br />PROVISIONS OF LAWS ANC ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOIJS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THF <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF ^F THIS PROPERiY TO PERFORM THE WORK F09 WHICH <br />APPLICATION !S MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18 �7 RCW AND 296.7.00 WAC. <br />X��/ /j�.L��� T_/�.-G -1 <br />sm n. �e.s <br />----......._.._ <br />N0. TYPE OF E�UIPMENT <br />A/C--A/HNDLG UNITS—H.P. <br />f-ORCED AIR SYSTEMS—B.T.U. <br />� UYI' fiEATERS—B.T.U. M <br />/ CL07HES DRYERS <br />VEpTILATION FAN <br />�' RAWGE HOOD <br />WATER HEATER <br />WC)OD STOVE <br />MFTAI FIREPLACE 1 <br />FIFlEPLACEINSERT <br />H[AT PUMP <br />GAS PIPING <br />E)'HAUST FAN <br />SUB <br />__L TOTAL FEE S <br />`�tA �i+n C�/c (sc UI <br />PLANCHEGK!IUMBER FEE RE <br />�/czs5�c2 -c��� <br />VACANT SITE FEI3S <br />C YES ❑ NO gUILDING <br />occu�+u� xoormvEwrvcwurs <br />?}F02 1 PI_UMBPJG <br />B EMEN� MECHANICAL <br />Ci YES i �' NO <br />HEIGHT LIMITATION ADOITIONAL PI AN CHECY. <br />,� � � O7HER <br />S7A7E BUILDWG SURCHAqGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 rora� <br />