Laserfiche WebLink
APPLICATIC�� FOI: CONSTRUCT"lN PERMIT � <br /> TO BE COMPLETED !N BLACK INK—PLEASE PRINT <br /> LHE� ATING Sl'STEM: GAS ❑EIECTRIC ❑_ <br /> FiUILDI�di:, DEPARTMENT <br /> 259-8810 <br /> I-1 DEMOLITION ❑ COMBINATION )G BUILDING j�C MECHANICAL ' � PLUMBING ❑ SIGN <br /> OWNE9 AILA��FES: <br /> CITY 2iP PHOUE <br /> �r�E�vTu►2� �Z .T..�c-• o'�? qs.d�- 57*61� S f ���i.w,�4 e.��9�7Z•S/b'6•739s' <br /> TENANT MAII(DORF.S': GITY ZIP PMONE <br /> 1 es.q.� G,�..ee , /1�� � c .�.c �'unr•�.-r� 3s3-�t-- <br /> Aqr�HITECT C DESIGNER MRIL AbDRE?5 CITV Z'P PHONE <br /> 11diJE.�mo��t�lf ��rr.as 'Z2 92 �i�S7 *"� �PS t �oePcoN�t�i�4. `t�7��'NSS��• 73'�S <br /> G�+,ERAL CONTRACTOR MAI�ADJRE55 � � �'�u'/� ^���� • ��� /��S <br /> I n DQ,tJ�L?6�1LL+-►' 2�Z2U P�� L��F,y..�r'+ �� — <br /> M CHRNiCALCONTRRGIOR MAILADCRc55 � LITY 21P �'NONE STATEIICENSE <br /> I'v lu =�-r--f-'�ir��Jl — $2.1-US3/ <br /> P.UMBMG ONTNAGIOR MAIL AOOR?SS CITY '�P PHOkC STATE LICENSE• <br /> GONTRACiPRICEOFWORK � vt. '��•��WS T�O�• �,�95 <br /> 5� /6 ./6 di �;.,:�Gd-fi 3iL S <br /> DESCRI§E�WORA"'ID SPU(RE�FOOTAGE INVO_`1ED COKiAGT PERSON AN�PHJNE N0. <br /> LCA�►YtJIt�MO _ <br /> i HEREBY CERTIFY THAT I HRVE READ AND EXAMINED THIS <br /> PflOPOSE SE OF BUILDING APPLICATION AND KNOW THE SAA1E TO BE TRUE AND CORRECT.AlL <br /> PROVISIONS OF LAWS AND ORDIN�INCES GOVERNING THIS TYPE OF <br /> LEGRLDESCRIPTIONOFPROPERTVISHOWkBFLO�.' ATTAGMTWOGOPIes� WORK WILL BE COMPLETED WITH 'NHETHER SPECIFIED HEREIN OR <br /> b � ��, aJT NOT. THE GRANTING OF A PERMII" DOES NOT PRESUME TO GIVE <br /> �aT—L--- s�ocrc oF AUTHORITY TO VIOLATE OR CANI:EL THE PROVISIONS OF ANY <br /> 6��/ �r��_ � )_� ��� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.l"HAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEHFORM THE WORK FOR WHICH <br /> APPLICA ON IS MADF. AND I CUMPLV WITH THE STATE <br /> PARCEL TAX I.D.NUMBER CONTR RS LAW 1827 RCW AND 296.200 WAC. <br /> COr15TRUCTION LO�N IENDER.AODRESS,TELEPHOHF NUMBER /� �fi3 <br /> � _S► <br /> ��r„�,w er.�_ \eIL{R O- onre <br /> :�r•� <br /> PROJ CTADDRE° ertvouswcssiKexserw <br /> PLUMBING • MECHANICAL <br /> NO. TYPE F FIXTURE OR�TEM FEE NO. TYPE OF E�UIPMENT <br /> FEE <br /> WATER CLOSET(TOILET) f I � -f' A'C—A/HNDLG UNITS—H.P. ' <br /> � FORCEDAIRSYSTEMS—B.LU3VM E.A. � ' <br /> BATHTUB � ' <br /> LAVATORY(WASH BASIN) � 4 UNIT HEATERS—B.T.U. M � <br /> � SHOWER � CLOTHES DRYERC, _ <br /> � KITCHEN SINK 8 UISP � VENTILATION FAN <br /> ( DISHWASHER RANGE HOOD ' <br /> ( WATER HEATER � <br /> LAUNDRY TRAY yypOG STOVE ' <br /> CLOTHES WASHER � ;` <br /> �' URINAL ' �� METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN _ � �- FIREPLACE INSERT <br /> .r FLOOR DRAIN � HEAT PUMP �— <br /> �.— BACKFLOW PREVENTERS ; GAS PIPING _ , <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN /// ' <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � <br /> � <br /> SUB TOTAL $ — SUB TOTAL 5 —_ <br /> PERMIT $ �� PERMIT 5 � <br /> TOTAL FEE $ ' TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: Rece r+o <br /> ' P�pNCHFCNNUM� FEF. O <br /> PRONTSETOALK AEARSETBACK SIDESETBACK <����� 3�-� 3� � /3 <br /> Z0� � ' /o'iArq[ �R 5 <br /> FEES VALUATION FEE� <br /> i 6E Z0� � LOT RREA�� VAGANT SITE _ <br /> j` 1 yYES ❑ N� Bl11LDING � � � <br /> IVPEOF'ONSi. NO.OFSTORIES otarlNp NaawrtitnLuenS <br /> • I n �ao5'; � PLUMBING <br /> !i •3 � � <br /> IZEOFBLoG FlRESPRINNLERSPEO'D BASEMENT MECHANICAL <br /> Iq9d5� Sf t � �YES ,^ NO � 1 <br /> t(�U Sr .+ ' ADDITIONAL PLA�!CHECK � <br /> OCCUPANCV Lb � FIRE ALRRM REO'D MEIGHT�ITATIOI� � <br /> 'AIbN � � — <br /> , <br /> REASON STATL BUILDING SURCHAFGE <br /> INTANEBY PUNSAPPROVEDBY CITY OF EVERETT f'UBLIG WORK$ ��� ^ <br /> LOCAL SALES 79 � 2.� <br /> oA,E TAX CODE IS 3105 rorn� � <br />