Laserfiche WebLink
APPLICATIC"1 FOR CONSTRUCT'"`1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT L <br />259•8810 <br />f 1 DEMOLITION ! ! COMBINATION <br />OWNER / IAFILAD/P RESS ;7 <br />_1 i id/1fY /�Pal'on /C% <br />TENANT M1IMLADORESS <br />OR DESIGNER <br />�,�i/%/ipil� <br />MECHANICALCONTRqCTOR <br />PLUMBING GONTFFCTOR <br />CONTRACT PRILE OF WOfyt <br />Y <br />DESCRIBE WOfiII AND SOIIAI <br />MAIL AOORESS <br />MRII A�DRE55 <br />MFIL RDOPE55 <br />FOOTAGE <br />PROPOSED USE OF BUILDING � <br />LEGAL DESCRIPTION OF PpOPERTV �SHOWN BE101 <br />�or— e�ocK oF <br />PARCELTqX10 NUME <br />r � <br />CONSTRUCTION LORN <br />PLUMBING <br />N�— <br />WATER CLOSET (TOILET) <br />dATHTUB <br />LAVATOFY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDFYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR. ETC.1 <br />�/ � <br />NUh18ER <br />HEATING SYSTEM: �' GAS J ELECTRIC <br />SUB TOTAL 5 <br />PERMIT 5 <br />FOR OFFICE USE ONLY: <br />FRONT SETBACF / REAR SETOACN � <br />� <br />USEZONE � IOTARFA <br />� <br />rn�e ov causr. <br />� <br />sizE oF o��c <br />2 f. <br />OCCUPANCYLOAD <br />INiANE BY <br />FIRE SPPINKLERS REOD <br />FIR[ A�AqAI R[O <br />Nv <br />PL�NS <br />onre <br />BUILDING <br />dTY <br />❑ MECHANICAL <br />21P PNONE <br />S�o_Sc, _3v % <br />21P PHONE <br />❑ PLUMBING I SIGN <br />CITY ZIP PHONE <br />CITV ZIP PHONE STATEUCENSE9 <br />qTY ZIP PHONE STA7ELICENSE� <br />GITV 21P PHONE STFTEI�CLNSE• <br />FEE <br />CONTACi PERSON ANO PHONE NO. <br />i HEREBV 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 />AUTI�ORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTiUN OP. THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS P, �OPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />X %%vii�r.te, f�io�n�J 8 -/v - 95' <br />S�GN.1iUn[ 04E <br />Clrv pU8NE55 UCENSC NG <br />MECNANICAL <br />N0. TVPE OF EOUIPMENT FEE <br />A/C—NHNDLG UNITS—H.P. ; <br />FORCED AIR SYSTEMS—B.T.U. M E.P. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGE HOOD �— <br />WATER HEATER <br />WOOD STOVE ; <br />METAL FIREPLACE (WOOD BUHNING) � <br />fIREPLACE INSERT ; <br />HEAT PUMP —r— <br />GAS PIPING ; <br />E%HAUST FAN � <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />� �� L <br />�l�,ni , �;•(. <br />SIOESETBACK J PLANGHECK�1lIM8[R FEE FECEIPTNJ <br />/ <br />� �' J� �'� <br />vncnNT site � FEES <br />I .�. YES . �, NO BUILDING <br />;;curwrr xoa�ewnuveuvns - <br />caaur FLUMBING <br />�ASEMENT �� � MECHANIr,qL <br />, YES V NO <br />NEiGHi �mutnTiON ADDITIONAL PLAN CHECK <br />Z , O7HER <br />STATE BUILDING SURCMARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />