Laserfiche WebLink
1 <br />APPLICATIUM FOR CONSTRUCT NON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />III DEMOLITION I COMBINATION I 1 BUILDING <br />TENANT MAII. ADDRESS CITY <br />I l MECHANICAL I I PLUMBING I SIGN <br />PAO <br />PHONE: <br />ARCHITFCT OR PESIGNER MAIL ADDRESS CITY ZIP PHONE <br />PLUMBING CONTRACTOR MAIL AOURE55 CITY ZIP PHONE STATE LICENSED <br />CONTRACT PRICE OF WORN <br />HEATING SYSTEM: []GAS I )ELECTRIC n <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CON! ACT PERSON AND PHONE NO. <br />9�'✓xslJi�L CAL iiu i¢.v;�y' <br />I HEREBY CERTIFY TOOT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHFTHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOEC NOT PRESUME TO GIVE <br />EGAL DESCRIPTION OF PROPERTY (SHOWN BELOW 4R ATTACH TWO COPIES) <br />►Y <br />LOT �� BLOCK 7 r—'i 1!0Ci4P1 Tlf4- <br />AUTHORITY <br />_L_ or <br />TO VIOLATE OR CANCEL THE PROVISION 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 />CO FACTORS LAW 18.27 R AND 296.200 WAC. <br />CEL TA\ LD. NUMBER <br />/Ljtd QS <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />X 1 �p I <br />D�iAATTE <br />SIGNATURE <br />_ <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />_ <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS — H.P. <br />1 <br />BATHTUB <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />, <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />; <br />DISHWASHER <br />' <br />VENTILATION FAN_ <br />I <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />URINAL <br />' <br />WOOD STOVE <br />' <br />-_ <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />I <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />' <br />SINK (SERVICE — BAR, ETC) <br />I <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />; <br />I <br />SUBTOTAL S <br />SUB TOTAL S <br />; <br />PERMIT S <br />I <br />PERMIT S <br />I <br />TOTAL FEE $1 <br />TOTAL FEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR S!:TBACK <br />SIDE SETBACN <br />PLAN CIIECK NUNBFR <br />FEE <br />RECEIPT NO <br />USE ZONE <br />TOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />--- <br />nreS n No <br />BUILDING <br />; <br />Y.EIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDGRI. <br />UVITS <br />PLUMBING <br />I ' <br />OCCUPANCY <br />NO OE STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />I <br />GROUP <br />MECHANICAL <br />I <br />nVES II NO <br />ADDITIONAL PLAN CHECK <br />, ' <br />ILARM RED <br />REASON <br />OTHER <br />i <br />FIRE SPRINKLER REO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />' <br />TYPE OF CONST. <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TOTA <br />DATL <br />TAX CODE IS 3105 <br />