Laserfiche WebLink
NFU <br />APPLICAT14.4 <br />FOR CONSTRUCT. JN <br />PERMIT <br />E'YL•IL'll <br />IAI EvINPNNP!1 TO BE <br />COMPLETED IN INK —PLEASE PRINT <br />CRYOF <br />everett <br />HEATING SYSTEM: U GAS U ELECTRIC <br />BUILDING DEPARTMENT <br />259.8810 <br />f I DEMOLITION I I COMBINATION <br />❑ BUILDING )0 MECHANICAL <br />I I PLUMBING <br />I SIGN <br />OWNER MAIL ADDRESS <br />CITY ZIP PHONE <br />Jb1a S or,l - 5cs `R`U wx370? <br />56-We q 24 2�-ko Z (*5 <br />TENANT MAIL ADDRESS <br />CITY _ ZIP PHONE <br />APCHITECT 00 DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />­!iwr A, 3A vis D+1 Z 70 7 PRISCC PoV A Seattle uh`t % 119 o7sa-S44(o _ <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />/tiIC 4, (U• '1.0. Z49o7 S°atVc � cM2q 762-3311__---F11(.VjfV**37200 <br />PIUMBWG CON TRAC R MAL ADDRESS CITY ZIP PHONE LICENSE <br />NEW 1 1 ADDITION I I ALTERATION LJ REPAIR U DEMOLITION I I WOODSTOVEIFRPLINSERT 1_1 BUILDING RELOCATION <br />CONE RAC T PRICE OF WORK <br />CONTACT PERSON AND PHONE NO. <br />IVA. Q <br />DESCRIBE WORK ANO SQUARE FOOTALGE INVOLVED <br />YNUSiTr4\ 1F1111'T{Gr <br />7 2-33u 193 <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 OATS <br />X n <br />hilt K�IL\�YU L�. <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOWGR ATTACH FOUR COPIES) <br />LOI BLOCK OF <br />5X3 lnl S-,M S:7�G3 <br />PROJECT ADDRESS <br />APPLICANTS CITY BUSINESS UOENSENO AN USINE55 NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE 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 />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVAT0:7Y (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />I _ <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />_ <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />I _ <br />SINK (SERVICE —BAR, ETC.) <br />I <br />SUB TOTAL <br />$ <br />I <br />SUB TOTAL $ <br />O <br />PERMIT <br />S <br />PERMIT $ <br />_ <br />TOTAL FEE <br />$ <br />TOTAL FEE S <br />Uo ' ` <br />FOR OFFICE USE ONLY: <br />FRCNT SETBACK <br />REARSETEACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE i� <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE Of CONIS ATLOWASR F <br />IYFT OF CONST ACIUAL <br />atuoAKCY <br />WIN MILK MIM <br />.c <br />I <br />PLUMBING <br />—r— <br />SIZE OBLDO <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />I <br />ADDITIONAL PUN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS PEGG HEIGHT LIMITATION <br />OTHE <br />- <br />REASON FOR SPRINKLERS <br />1 <br />STATE BUILDING SURCHARGE <br />i <br />NRAKE BY <br />PL <br />i M E(MYT <br />CITY OF EVERETT <br />PUBLIC WORKS <br />I <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />yQ, ; o0 <br />