Laserfiche WebLink
APPLICATI� FOR CONSTRUCT �N PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259•8810 <br />I_] DEMOLITION '� i COMBINATION �'..-BUILDING I i MECHANICAL 17 PLUMBING L i SIGN <br />OWNER MAILADDRESS CITV 21P PRONE <br />J�Sc.ck v�raq <br />J�»,=c ncaws�ro 26z� G-Pw.�o M�a�v� �.rEc�'A' �B7a (-tec)�.36-363� <br />TENA,NlT �- MPIL ADDRESS CITV ZIP PHONE <br />S/�TA` <br />ARCMITECT OR DESIGNEN MAIL ADORE55 GITY 21P PMONE <br />IS70 �2�S1lLR,'i <br />MAIL ADORESS //+ / <br />1 .l'r11.11 <br />PLUMBING CONTRACTOR MFIL ADORESS <br />CONTRAGT PRICE OF WONH <br />2i o��.� <br />DESCRIBE WORK RND SOIIANE FOOTAGE INVOLVE <br />cxuoua+� }bl�nou cfi eNSTt <br />�DIN� Z i1�� 13K f� _ <br />PROPOSEDUSEOFBWLDING %J <br />�a�-., i--tn .� � - <br />CITV ZIP PHONE <br />CITV <br />DESCRIPTION OF PROPENTY �SHONT! BELOW OF ATTAGN TWO COPIES) _^.�{- <br />I i- BLOGN GI 'Jr CF Gi� �1 Cfi F�(CK� U <br />9—�2 M9 s �� Pc.�M <br />!AL Al t-� � RI] 2. 2 tt . qt Au ..�ls ......ir <br />PAPLELTA%LU NUMBER <br />si3�ll - 615'- Doy - ooco <br />CONSTRUCTION IOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />PROJECT ADDRESS <br />Z6z3 G—¢t»1n Ha1�111l� �VP-P-� <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />LAVATORY�WAS <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTRAY <br />URINAL <br />DRINKING FOUNTAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SUB TOTAL $ <br />PERMIT $ <br />FOR OFFICE USE ONLY: <br />FR/OJN/T'S�ETBACK REARSETBACK <br />/-v i'-�i/ <br />USE20NE LOTAREA <br />R- <br />TVPE OF CONST. NO. OP STORIES <br />� I <br />S2E OF BLDG. FIRE SPRINKLERS REO'D <br />I'.� •`� IUU <br />OCCUPANCY LOAO FIRE FLARM REO'D <br />2 �.b <br />NEASON <br />INTRNE BV PLANSAPPROVEOBY <br />J►��I <br />DRTE dJ.e _ � .._ <br />SIOE <br />FEE <br />0 <br />❑ YES ��i NO <br />OCLpo�N[v NO OfpN4LlWGp41i3 <br />GNOp� <br />B2 .� <br />BASEMENT <br />❑ YES � NO <br />HEIGHT LIMITATION <br />-s r 1 <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS 3105 <br />I <br />ZIP PMONE STATE LICENSE � <br />ZIP PHONF STATE LICENSE 1 <br />PERSON AND PNONE NO. <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 GOVERN�NG THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT 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 />CONTRACTORS LAW iB27 RCW ANC 296200 WAC. <br />x f�Y�'�+� f aa�rr�lce.�Y� �4A4CIk *-�". ��D3 <br />S�GN4iU�F �� � �'� D�tE <br />N0. I TYPE OF <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATGRS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />METAL PIREPLACE � <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUSTFAN <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDI710NAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHAFGE <br />PUBLIC WOFKS <br />TOiAL <br />SUB TOTAL $ � ' <br />PERMIT $ � <br />N <br />H <br />� �� <br />