Laserfiche WebLink
..._.. ....."".. i ..�..... .�.. . .. '� , . ....._. . .... .:-.l:i:t .L�f.-_3•�.4L1' �,........_. ,.....r. , l+ .___"_.'._:�'.i.FPaY;SS:�uI'Ei�l.i'1�1 . <br />APPLICAT vN FOR CONSTRUCS� �ON PERMIT <br />the E�rerpreen <br />an oF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />�7 DEMOLITION D�. <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />>N 1=1 BUILDING Ll MECHANICAL <br />everett <br />e <br />❑ PLUMBING ❑ SION <br />�Pc��«. N�w�o,ti. ►032s PP��Ea�'• l�kE�;�,,:Ni 4�zsts 3�y-62ss <br />TENANI' MAIL AODRE55 CITV ZIP PHONE <br />� <br />ARCHITECTORDESIGNER MMLADDRESS CIN ZIP PNONE <br />O�SI6� CoNS�-�ltwTS -1dI 2"—"s�. Yt'�Nk-��TEo Q$2'7S -1�lS-�5�� � <br />QENEf�LCONTpACTOfl MAILAOORE55 CITY 21P PHONE LICENSEt <br />QAc�F'�� �'iA„�.''t�w �c1'�25 DAv�Es �Jc;�S'�E.>Er�s 9'12SFS 3�-Gz3� PE�c.�FHc���+w� <br />MECHANICALCONTMCTOR MR'.AODRESS CITY ZIP PMONE LICENSE/ <br />A�G 1-��in�b 3931 �»,,.m� �.,:..-�Z I'Y�ot 25L-o��ly <br />KO'P1N�o�i �'7�0� 5.�. �c��Ww �s.�y <br />CLASS OF WONN <br />�.Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR <br />TLNNiTIMPflOVEMENTOHINTERIORREMODELONLY "O <br />` I� <br />CONTiUCT PRICE OF WOHK: � �OF <br />DESCRIBE WORK AND SOU�flE �XITAGE INVOLVED p, <br />fV£w RSc_S�OEnYt��r�. rLC�GO <br />PIIOPOSEDUSEOFBUILDING � <br />LE(UL DQESCRIPTION OF PPOPERN (SMOWN BELOW OR ATTRCH <br />LOT_ lJ BLOCK � OFT�A-�'A' <br />ADDflE55 ��� <br />TYPE OF <br />WATER CLOSET <br />SHOWER <br />KITCHEN SINK & DISP <br />FLOOR DRAIN <br />BACKFLOW PREVENTEFiS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.1 <br />FRONTSETBACN <br />25' <br />USEZONE <br />S r .S. <br />IYPE OF CONST. AILOWABLE <br />1L-A(- <br />S�?—�—��'�4 'tL <br />OCCUP CAN YLHA�� <br />PFASON FOR SPflINKLERS <br />APPLICATION AC':. BY <br />❑ DEMOLITION <br />� coNr�ci <br />4_ f <br />SUBTOTAL 5 ;^ <br />PERMIT $ -�+-, <br />TGTAL FEE S 1'� <br />REAHSETBRCN SIDESETB�CK � <br />2S' '�,S <br />LOT AREA � V�CANT SITE <br />I�I Wc�A �9 YES O NO <br />1YPEOFCONST.ACTIIAL �'�PAHCY MOafPMIUNGUNnS <br />V_ U �:°'� 1 <br />NO.OF5T0lilES BASEMENT <br />2 )9. YES ❑ NO <br />FIHESPflNKLERSREO'D HEIGHTLIIAITATION <br />❑ YES jA NO Z � � <br />PUNS <br />CITY OF EYERETT <br />LOCAL SALES <br />TAl( CODE IS 3105 <br />ZIP PHONE LICENSE I <br />q$za-1 3ss-6�'tl '2-��l K�P2"12c2 <br />❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />PERSON AND PHONE NO. <br />t�t �u,n�� 33v-�z <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICA'fION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINO 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 OP THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRP.CTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGN�TUREOfCONTftACTORORAU HOFIZEDAGENT DATE <br />�a+�b.2�N` \ ' ����q" <br />X ��c�F«. �-i�n�.�o,.- CoN� � -� +�c• <br />APPLICANTS CITY BIISME55 LIGENSE NO. AND BUSME55 NpAIE <br />u�nu�u�nu <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />WATER HEATE <br />WOOD STOVE <br />METAL FIREPL <br />FIREPLACE W; <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />STA�OTHER �1-Y-W�C�C- <br />Il.DING SUPCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />SUBTUTAL S �>;� <br />PERMIT $ � <br />70TAL FEE S ' � <br />FEE REGEIPTNO. <br />46f� 3 <br />VALUATION FE'EII{ <br />`t'� � <br />nf„ �- <br />•;: t <br />� <br />