Laserfiche WebLink
pPPLICATI� FOR CONSTRUCT��N PERMIT <br />everett <br />«E�ro,�� e <br />CITY OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259•8810 <br />❑ DEMOLITION f I COMBINATION Stl BUIIDING f I MECHANICAL I 1 PLUMBING ❑ SIGN <br />OWNEP MAII AO�RESS QTY 21P �IIONE <br />Gany Han.Ceea 5308 Sou.th 2nd Evenett 98203 252-1761 <br />TENANT MRILFDDRESS CItY ZIP PMONE <br />Same as above <br />ARCNITEClOR0E51GNER MRILA�ORE55 GTY 21P PNONE <br />VIUV7C'h <br />GENER�LWNTRACTOfi MAILTDDRESS CITY 21P �MONE LICENSE� <br />MR. BLIILD U1i.CCianb Conhx. &929 4tli PC. S.E. Evehett 98208 743-1925 �IRBUI('�C142JJ <br />MELH�NIC�LCONTR�CTOR MMLADDRESS CIiV IIP PNONE LICENSE� <br />NUNE <br />PLUMBINOCONiRAC70R MRILpDORE55 G7Y 21P PHONE LICENSE� <br />GUSS OF WO��K <br />f7 NEW L I ADDITION [YI ALTERATION I I REPAIR I I DEMOUTION I I WOODSTOVE/FRPL INSERT I I BU�LDING RELOCATI <br />TENANT IMPROVEMENi DA INL[RIOR REMODEL ONLY <br />LONTRACTPPICEOFWORK: ��29&•00 <br />OESGRIBE WORN �ND SOUARE FOOTFCE INVOlVEO <br />Repaih dny no.tted {noitit �: <br />PROPOSEO USE OF BUILDINO <br />En.t�cu Zo Itome <br />LEOAL DESCNIPLION Of PnOPEt11V 15110WN BELOW � <br />LOT BIOLK �F , <br />BPIz-023-�-00-S !z La.t 2 <br />N5003-023-002-000G <br />WI.C'�1 I1CN <br />COPIES� <br />PNQIECTAO�RE55 <br />5308 Soi�th 2iid, �vexett, U.�a. 98203 <br />PLUMBINQ <br />NO. TYPE OF FIXTURE OR ITEM � <br />SINK 8 <br />HER <br />'TRAY <br />DRINKING FOI <br />FLOOR �RAIN <br />FAONT SETBI.CK <br />usEzone <br />iYPE Of CO45i. PLLOWABL[ <br />�� <br />61iE Of BLDG. <br />/D _ S, F. <br />O.C�CUP�A�NCV�LOAO <br />�i..M1 <br />RE�SONfOqSPRINNLERS <br />RERRSE7BACN <br />LOT AREA <br />IYPE Of CONSt. PCIURI <br />� � <br />NO OF STO I[5 <br />FIR� NNlERS BEOD <br />I I YES � NO <br />APi'UGA710NACC.BY �lANSGPPROVEOfiV <br />9� <br />( <br />)TAL $ <br />—� <br />f $ <br />FEE $ <br />sioe seiencK <br />VACPNT SITE <br />I I YES I I NO <br />acurexcr xa w mvuuxt <br />i i ves a No <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX COUE IS 3105 <br />7 �y't 1.1(� <br />, if'��� • ` <br />CONIACT PERSON ANP �'� WnE n0. <br />I HEREBY CERTIFY TI1AT I HAVE READ AND E%AMINED THIS I <br />APPLICATION ANU 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 i <br />OTHEfl STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE 'i <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUiHORIZED BY THE i <br />OWNER OF THIS PqOPERTY TO PEFFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE I <br />CONTRACTORS L�W 18.27 RCW AND 296200 WAC. <br />SIGNAIUREOFCONiRACtOf10R�UT110R�Z[O�GENT DATE <br />ANICAL � <br />TYPE OF EOUIPMENT FE <br />NC--/VHNDLG UNITS—H.P. <br />FORCED �IR SVSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEI100D <br />W�TER HEATFR <br />WOOD STOVE <br />MET�L FIREPLACE & CHIMNEY <br />FIfiEPLACE INSEHT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL $ <br />PERMIT S <br />TOTAL �EE $ <br />_c 1{ur�C:�! �-' ree�l��� �E��PT�--�-�1 <br />n� <br />FEES VALUATION FEE <br />G:�_� �� .—I) ��, /�.'i/i �� <br />PLUMUING <br />MECH�NICAI <br />01HER <br />S7ATE OUILDING SURCHARGE <br />S1AtEENERGYSURCHARGE <br />ruouc woaks <br />70TA1 , <br />i., <br />�x.0 71tt _ '�� <br />P� <br />% <br />