Laserfiche WebLink
C H <br />9Hfn <br />H � H <br />rA <br />K n <br />H x! <br />oxo <br />i1 H Kil <br />1-3 <br />C7OE <br />HC <br />HaZH <br />t�Hz <br />HH <br />H <br />Ci tl CA NxHEA <br />HOCA <br />APPLICATION FOR CONSTRUCTItoN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8810 <br />j l DEMOLITION I I COMBINATION 1 I BUILDING I I MECHANICAL I! PLUMBING I I SIGN <br />OWNER MAILADDRESS CITY ZIP PHONE <br />s.' / L y �i= Gvztr rT 3Poo wermexa, ✓J= P .1 PILW <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />CITY ZIP <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />J`•_NJIRPER CnurJir7CTc 8 is /sr/iVr Sa�riJ S �ntti 98io4 �6�-11383 1119jePCrRa187 <br />h1EC11ANICAL CONTRACTOR MAIL GORES CITY ZIP PHONE STATE LICENSE <br />CONTRACTOR MAIL ADDRESS <br />ZIP PHONE <br />CLASS OF WORK <br />i i NEW I I ADDITION I I ALTERATION I I REPAIR IX; DEMOLITION I I WOODSTOVEFRPL INSERT I I BUILDING RELOCATION <br />CONTRACT PRICE OF WORK <br />CONTACT PERSON AND PHONE NO. <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Aemot�t3la S/R <br />PROPOSED USE OF BUILDING <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 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 18.27 RCW AND 296.200 WAC. <br />X'"/� <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIESI <br />LOT m A?��3oBLocK I <br />��% S 7� OF ,[demur.-rr�AND ie: L <br />PROJECT ADDRESS ` <br />O L J L L 7- <br />sK.NAiunE <br />DIRE <br />CHYBUSTIES.UCENSENO <br />PLUMBING <br />MECHANI <br />Al <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILEI) <br />ANC—ANHNDLG 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 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />T <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVLHITERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />T <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT $ <br />—�— <br />_ <br />PERMIT $ <br />TOTAL cE $ <br />_ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />GEM SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />37� <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />_ <br />FEE <br />BUILDING <br />TYPECECONTS. ALLOWABLE <br />TYPE DE CONST. ACTUAL <br />CRUP"" <br />Gawp <br />I NJCEB•HIHNGUNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO OF STONES <br />CASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS RED D HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />SPRINKLER <br />STATE BUILDING SU^f,HARGE <br />U f?J <br />INTAKE BY <br />7PROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />y <br />