Laserfiche WebLink
APPLICATION FOR CONSTRUCTION PERMIT L <br />the ENcrpmen TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett -- -- - <br />BUILDING DEPARTMENT I HEATING SYSTEM: U GAS U ELECTRIC U <br />259-8810 <br />I DEMOLITION i I COMBINATION I I BUILDING I MECHANICAL I I PLUMBING I i SIGN <br />' CITY ZIP e�PHONE <br />_Ck <br />l(n v�IKj j7 <br />ZIIONETELTANIMAIL ADDRESS <br />.----_-- <br />All llE 11 oil DESIGNER MAIL. ADDRESS ---- 1'!{CITY ZIP PHONE --- - <br />ZIP PHONE - T I ]CURSE N <br />"' PHONE ♦I►A�',HR►SfZIIaINC <br />I'LUMBINGGCOONI�NCCIAOR MAIL ADDRESS CITY ZIP PHONE LICENSEN <br />UBI <br />CLASS OF WORK <br />I I NEW I I ADDITION I I ALTERATION REPAIR DEMOLITION i WOODSTOVE,FRPL INSERT 1 i BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK <br />--- -- <br />SC WORK A,D SOII RE FOUiAC,E INVO VFU �-- <br />_ ♦ �y�Q /Q/ �/� <br />�L1 �•11�� ��. k _ U L/ . - <br />N ���,� <br />f '\^/� <br />T.l�i.i us__ <br />PROPOSED USE MUILDING U <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />f2mI <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PROPERTY ]SHOWN BELOW OR ATTACH FOLIRCOPIESI <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK of <br />NOT. THE GRANT114G 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 />---------------- <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SICNAIIIREOFCU14iRACTOIIURA011101 AGENL OAT <br />PROJECT ADDRESS <br />1r ) z i <br />APPIICANTSCOYDIISIIIESSIICENSEND ANOBUSMESSNAME <br />PLUMBING I-/ <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />_WATER CLOSET (TOILET) _ _ <br />FEE <br />_ <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />_— <br />ArC—AIIiNDI.G_UNITS—H.P. <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />�— <br />UNIT HEATERS—B.T.U. M <br />; <br />_ <br />SHOWER_CLOTHES <br />_ <br />DRYERS <br />�— <br />KITCHEN SINK & DISP <br />; <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />1 <br />WOOD STOVE <br />URINAL <br />I <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />_FLOOR DRAIN <br />I <br />1 {EAT PUMP <br />--'— <br />BACKFLOW PREVENTF-RS <br />; <br />GAS PIPING <br />ROOF DRAINS —RAIN EADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />—— <br />T <br />I <br />— <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />_ <br />PERMIT $ <br />TOTAL; EE $ <br />' <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PI AN CHECK NUMBER <br />I LL <br />RECEIPT NO. <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />------- - <br />D6 <br />ME OF CENTS ALLDWABIF <br />TYPE OFCONST ACTUAL <br />gtuNtHCY <br />`NWP <br />NO gBATIInW UNITSBUILDING <br />PLUMBING <br />1 <br />1 <br />I <br />SIZE OF BLDG <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />— <br />�— <br />ADDITIONAL PLAN CHECK <br />; <br />OCCUPANCY LOAD FIRE SPRNKI ERS REO'D 0/EIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />OTHER <br />-- <br />i <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PUNS APPROVEC BY <br />CITY CF EVERETT <br />LOCAL SALES <br />TAX CODE IS 310b <br />PUBLIC WORKS <br />' <br />TOTAL <br />/� 50 <br />