Laserfiche WebLink
- - — -� - � - � � �;��c <br />, 1 APPLICATION FOR CdNSTRUCTION IPERMIT �::�� <br />� ;� <br />rn� ere,��� _. ,' J A � 1�l �< " everett <br />CITV OF `4 <br />................_............................................. ,. r <br />{. <br />everett CITY OF EVERETT �t! <br />BUILDING DEPARTMF�NT Pu�lic Works Dapt. :? <br />259-8810 TO BE COMPLETED IN INK—PLE�A E PRINT ,,?; <br />❑ DEMOLITION �� ❑ COMBINATION U BUILDING W1CAECHANICAL ❑PLUMBING ❑ SIGN '.? <br />OWNER MAI��DDRESS CITV 21P pqpNE �� <br />�.v�l.��. Com�n CXUan�h �OD3 d-I r�I1k� � 355 •q3�7 �. <br />TENMIT U MAILADOf1ES5 CITY 21P pHpNE ' <br />ARCHITECTORDESIONER MAILADORE55 CITY 21P P�i01;E ' j�, <br />GENEFULCONTRACTON MAIL�pORESS CITY 21P pHpNE LICENSEI <br />YECHANICALLONTRACTOR M�ILADDRESS <br />SaNtDe �nl�. �► �3o s <br />WUMBttlOCONTMCTOfl MAIUUDRE55 <br />CUSS OF WOIIK <br />LJ NEW 17 ADDITION I�ALTERATIC <br />7ENANT NAFROVEMENT OR WTERqp qEMODEI ONLY <br />CONTRACT PRICE OF WOR1t: <br />DESCRIBENIORKAN SOWREFOOTAGEINVOLVED <br />.s�Q� ('1�'� �P�11� � <br />PROPOSED USE OF�ILUIN6 /� <br />�� ,1. � <br />LEOALOESCRIPTpNOFPROP P Y�SIqWqgELOWOR <br />lOT BLOCK OF <br />�ri._u,���2s� � r�D I • , <br />PLUMBIN6 <br />O. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOIIET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN 81NK 8 DISP <br />DISHWASHER <br />UUNDRY TRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKINQ FOUNTAIN <br />FLOOR DHAIN <br />BACKFLOW PP.��ENTERS <br />FBONTSETB�CK <br />USEIONE <br />IYPE Oi CON51. �IIOWABIE <br />SIZE OF BLDO. <br />OCCUPANCVLOAD <br />PE�SON FOfl SPRWNLERS <br />APPLICQION ALC. BY <br />ZIP <br />I <br />�. �', `.:1;,, <br />� ' �'i <br />❑ REPAIR ❑ DEMOLITION f7 �NWDSTOVEIFRPLINSERT ❑ BUILDINORELOCATION <br />CONTACT PERSON �NU PHONE NO. <br />I HEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS I <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br />PHOVISIONS OF U1WS AND ORDINANCES 60VERNIN(3 THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br />NOL THE GRANTIN6 OF A PERMIT DOES NOT PRESUME TO QIVE �� <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGUTATIN6 CONSTRUCTION OR THE <br />PERFORMANCE OF (:ONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfl WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE BTATE ' <br />CONTRACTORS LAW 18.27 RCW AND 298,200 WAC. <br />SICN�TU EOFCIXJTpACiOROR�UTHORRED�OENT OATE <br />X UU1'Ll.ol(- VY1G � �� �3�2 : <br />APPLIC�NiSCI�YBUSINF55L ENS O.�NDBUSINESSNMIE �' � <br />FEE <br />SUB TOTAL E ; <br />PERMIT E � <br />TOTAL FEE S ' <br />flEMSETBACK SIOESETBACK PI�N <br />IOT�REA <br />TYPE Of LONST./�L7UAL <br />NO.OF STORIES <br />FIRE SPRNNLERS flEOD <br />U YES ❑ NO <br />PLANS APPNOVEDBY <br />VACANf SITE <br />❑ YES CI NO <br />otturu�tt xoaowtuixcuxns <br />cnav <br />BASEMENT <br />CI vEs ❑ Ho <br />HEIGNT LIMITATION <br />CITY Of EVERETT <br />LOCALSALES <br />TA)( CODE IS 3105 <br />FEE <br />A/C—lVHNDLG UNITS--H.P. <br />FOHCED AIR SYSTEMS—B.T.U. M E.A. ; <br />UNIT HEATERS—B.T.U. M ; ' <br />CIOTHES DRYERS T— . <br />WATER HEATER ' I^ <br />WOOD STOVE � r{� � <br />METAL FIREPLACE d CHIMNEY � I�'� <br />HEATPUMP � � <br />GASPIPING ! !,� <br />BU�LDIN6 <br />PLUMBING <br />MECHANICAL <br />OTHEH <br />STATE BUILDING SURG'�R�E <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE E <br />FEE I RECEIPTNO. <br />� <br />0 <br />