Laserfiche WebLink
APPLICATIS" FOR CONSTRUCTnIA- PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: GAS U ELECTRIC ❑ <br />259-8810 <br />l DEMOLITION CI COMBINATION 1-1 BUILDING "ECHANICAL Cl PLUMBING I I SIGN <br />OWNER ll �x�I I MAIL ADDRESS 11,, 1ACITY C, ZIP PHONE <br />MRAPmE I7�i' <br />6 f—k 00,4'1- 9?;?U3 3sS•5002 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />MAIL ADDRESS CITY ZIP PHONE STAT': LICENSE E <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY y� ZIP PHONE STAT?. LICENSE <br />�VIMPmn S'1'ta, $Mrs Mi'�ijJF ISOfj Cyrrt7/ gk2pL. 2.SA-311'( 1-:WA6S-S)Xfk-7 <br />PLU ING CONTRACTOR MAILADDREE CITY ZIP PHONE STATE LICENSE <br />CONTRACT PRICE OF WORN <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PEW AND PHON <br />f'. xsA•311N <br />oe- frfi'fA <br />I ton DI 4'o F, <br />sm If s rA«< <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE 9F BUILgING <br />KISE'.f f A C IT <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 TWO COPIES) <br />NOT. TH GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AN) <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 MADF AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />p <br />PARCEL TAX I D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />PROJECT ADDRESS <br />L <br />SK NAT °ATE <br />TI-TYBUSINESSLICENIL NO <br />172 o bfoo/\ <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EGUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. <br />LAVATORY (WASH BASIN) <br />_ <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <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 />_ <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL $ <br />' <br />SUB TOTAL $ <br />r ' <br />PERMIT $ <br />' <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />cno nccErc I ICc nAE1 V• <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AF I <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />❑ YES El NO <br />TYPE OF CONST. <br />NO.OF STORIES <br />acuwAn <br />xU Bi pWEIuxS UNITS <br />cxaF <br />PLUMBING <br />SIZE OF BLDG. <br />FIRE SPRINKLERS AEG <br />BASEMENT <br />MECHANICAL <br />❑ YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM REO'D <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />