Laserfiche WebLink
HyF,i <br />y H <br />HC 1-37d W <br />O H Fit <br />VJ H <br />OE <br />OHd�yy <br />H0O <br />YH3 <br />�yz <br />Hy <br />gc* <br />H <br />C'D C7N <br />LTt <br />z0Tn <br />yOEn <br />,17 <br />w l <br />APPLICATION FOR CONSTRUCTION PERMIT <br />t',L'Fotl <br />Coil ! 0I <br />everett <br />Le� <br />BUILDING DEPARTMENT <br />TO BE COMPLETED IN INK —PLEASE <br />PRINT <br />259-8810 <br />DEMOLITION COMBINATION <br />BUILDING <br />MECHANICAL PLUMBING <br />SIGN <br />OWNER MAIL ADDRESS <br />yow CPV <br />If' PHONE <br />Apl4tu /U. <br />r a� �'� <br />TS7 a30' <br />TENANT r MAIL ADDRES <br />CITY <br />ZIP PHONE <br />I�Pe <br />ARCHITECT OR DESK7NER MAIL ADDRESS <br />CITY <br />21P PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />MECHANICALCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />L <br />nl u w/. liL <br />k s//r (�iL <br />q� A <br />`hf o <br />aS9- 03pl <br />/1.E1116 A /�7 /lr <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LN;ENSE# <br />x NFW I"1 ADDITION Ll ALTERATION ❑ REPAIR ❑ DEMOLITION Ili WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br />1''ANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK: I F co <br />CONTACT PERSON AND PHONE NO. <br />DESCRIBE'WORK AND SQUARE FOOTAGE INVOLVED <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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTIONOF PROPERTY (SHOWN BELOWOR ATTACH FOUR COPIES) <br />LOT _ BLOCK OF <br />_J <br />l <br />PROJECT ADORES$ <br />nPPL IT CITY BUSINESS LICENSE .AN B INESSNAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIX) L'RE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET; <br />A,C—A)HNDLG 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 />' <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />' <br />-T— <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />_ <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ <br />_ <br />ROOF DRAINS—RAINLEADERS <br />_ <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL <br />S <br />SUBTOTAL $ <br />'Cd <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />ILE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANTSITE <br />C1 YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE OF CONST. ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />nCLuvmcPc. <br />Mo OffMTLLNG IMF ' <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />L i YES ❑ NO <br />MECHANICAL <br />' <br />OTHER <br />I <br />i <br />OCCUPANCY LOAD FIRE SPRNKLERS REOD <br />❑ YES ❑ NO <br />REASON FOR SPRINKLERS <br />HEIGHT LIMITATION <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />i <br />APPLICATION ACC. By <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORK$ <br />j <br />1 TOTAL <br />