Laserfiche WebLink
V� <br />APpLICATIO�:: FOR CONSTRUCY6��N PERMIT everett <br />TO BE COMPLETED IN INK—PLEASE PRINT � <br />the Evergreen <br />GTV OF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />❑ DEMOLITION ❑ C <br />OW ��� MAIL F <br />� <br />- N r � � MA14f <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC U I <br />�p r.�KSS�7/ <br />i J BUILDING L 1 MECHANICAL ❑ PLUMBING ❑ SIGN <br />' 1'JiY 21P PHONE � _ _ / <br />. ��7y a 21P PHONE <br />�pq�ESIG� MAILpODBESS iV 21P PHONE <br />'���GENEBALCONTRRCTOR MAILADDRE55 CI'Y ZIP PHONE UCENSEN <br />./ � '/' c•ni n�#-3o� � S�zi Tiv.ez�FCak/ObGs' <br />� S�JI�t) I=/l2� rrLlcrRliL.Tin.�� /7�0_) lz�L�S .� ��' <br />MECHIWICALCONTRACTOR MAIIADDAE55 CITV 21P PHONE IICENSEf <br />PLUMBINGCONTPACTOfl �.���lA0�RE5S CI7Y ZIP P110NE LILENSEN <br />� CLASSOFWORN � <br />j ❑ NE'�V CI ADDITION It�l'ALTERATION I I REPAIFl I 1 DEMOLITION I I WOODSTOVFJFRPL INSERT ❑ 6UILDING RELOCATION <br />� a CONTACT PERSOi� �NG �HONE NO. <br />DESCflIBEWORNAND5al1nREFOOIaue�nv vcv <br />� .�� orir� <br />PPOPOSED USE OF BUILDIDI6 <br />�q ct-{o ' e � / <br />LEG..L UESCHIPTION OF PRO RTY (SMOW4 BELOW OR r11 <br />l0T .._. __ BIUCK OF _ <br />SHOWER <br />KITCHEN SINK & D6 <br />DIStiWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />ROOF <br />� PEF <br />TOi <br />� FOR OFFICE USE ONLY: <br />� FRONTSETBFCN REARSETBACK <br />I <br />� USEZONE LOTAREA <br />I <br />( TYPEOFCONiS.�LLOWABIE fYPEOFCONSi.ACNRL <br />� SIZEOFBLDO. NO.OFSTORIES <br />I <br />PEASONFOfl <br />FIHE SPPNNLERS <br />\NS APPFOVED BY <br />��� � <br />� <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />coaiesl PROVIFIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE 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 IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZtD BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />— APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOflS LAYJ 78.27 fiCW AND 296200 WAC. <br />SIGNATUREOFCONTFACTOPORAUTf10RIZEDAGENT OAiE <br />X �I/) /1 l _ <br />SI]E SETBACK <br />FORCED AIR SYSTI <br />UNIT HEATERS—B: <br />CLOTHES DRYERS <br />VENTILATION F.4N <br />METAL FIRE <br />FIREPLACE <br />HEAT PUMP <br />CHECKNUMBER <br />VACMlT SITE FEES <br />BUILDING <br />OCLUD.INCY HOOipWRIMu•.. <br />�ROUP PLUMBING <br />�nSEMEN7 MECHANICAL <br />HEIGHT LIMITATION ADDITIONAL PLAN CIiECK <br />OTHEF <br />STATE BUILDING SURCHARGE <br />CITY OF EVEflETf PUBLIC WORHS <br />LOCAL SAEcS <br />TAX CODE IS 3105 TOTAL <br />M E.A. <br />CHIMNEY <br />SU6 TOTAL $ ; <br />PERMIT S � <br />--T— <br />TOTALFEE $ ' <br />FEE REGEIPTNO. <br />VALUATION FEE <br />�� � �00 <br />1 <br />� <br />