Laserfiche WebLink
>y <br />.ozs <br />r� <br />�a <br />H <br />Hey � <br />yy�� <br />m0C <br />0 H d <br />G) • n <br />z HH <br />APPLICATII. A FOR CONSTRUC-':ON PERMIT EVCFPi` <br />rrre evPmrcreR TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER AMIL ADDRESS CITY ZIP PHONE <br />Ld.�ur RAA ADDRESS CRY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERALCONTWTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSES <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSES <br />PIL ONG CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSES <br />✓ ., MCA,nl ITInM WnnnsmVFiFRPL INSERT BUILDING RELOCATION <br />INCYY .. HMVn v1. <br />CONTACT PERSON AND PHONE <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />lI 0 7 �/ <br />PROPOSEDUSE BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�L,� 1 e-Z r <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 />LEGAL DESCRIPTq PRovcnlY IOWNB LOW OR ATTACII FOUR COPIES( <br />LOT BLOCK OF <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 />SIGNATLRE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />PROJECT ADDRESS <br />APPLICANTS CITY BUSINESS LICE SE NO. AND OUSME55 NAME <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />AL—NHNDLG UNITS—H. P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />=MPERMIT$ <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />rvn vrrwc �.+� <br />vn.-I. <br />PLAN CHECK NUMBER <br />I[E <br />RECEIPT NO <br />FRONT SETBACK <br />REAR SETBACK <br />51DE SETBACK <br />USE ZONE <br />LOT AREA <br />vAGANT SITE <br />FEES <br />VALUATION <br />— FEE <br />BUILDING <br />—� <br />TYPE Of CDNis ALLOWABLE <br />TYPE OF CONS(. ACTUAL <br />P(TVFMKr <br />Mf dLMEHIK4IMi15 <br />APd1P <br />PLUMBING <br />SRE OF BLDG. —NO OF STORIES BASEMENT <br />MECHANICAL <br />i <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD FIRE SPRNKLERS REOD HEIGHT LIMITATION <br />OTHER <br />_ <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />!T— <br />LOCAL SALES <br />Trl( COOS IS 3105 <br />TOTAL <br />