Laserfiche WebLink
APPLICATION. FOR CONSTRUCTI..IN 1-ERMIT E'VirE1' <br />the Evergreen TO BE C')MPLETED IN INK —PLEASE PRINT <br />CIT(OF <br />everett [ HEATING SYSTEM: XGAS ❑ ELECTRIC xt� <br />BUILDING NEPARTMENT -� <br />259-8810 <br />DEMOLITION COMBINATION `)( BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADLRESS CITY ZIP PHONE /� <br />TENANT MAIL A CRE55 CITY ZIP PH NE <br />5WROML51 1 C✓ It 11 <br />ARCHITECT OR DESIGNER A RADDRESS CITN ➢P PHONE <br />P.. bw i 2 E uJA _ 9�9210 l� ?30-er.�l_ <br />GEN.'RAL CO TRACTOR AiL A0DRE5 1 CITY ZIP - ONTfI E IICENSEF �'Ir. (r 1�1� <br />`<<�F�T-��-� fL, u1.y��l�.IUA .9P20 (2ec)�53efy� <br />MECMANI AL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE ICENSI'• <br />&0-w. a�ANrs- <br />��LA z ,_�TNG 3332 G:OMt,_EUr t�%/. H✓A_982v�/ _2S2-ZWL <br />PLUMBING CONTRACTOR MAIL ADDRESS OF ZIP PHONE LICENSE. <br />If /1 �/ /( 11 // <br />CLASS OF WORK <br />NEW ADDITION VALTERATION REPAIR DEMOLITION WOODSTOVEtFRPL INSERT BUILDING RELOCATION <br />CONTRACT PHICE OF WORK <br />CONTACT PERSON AND PHONE NO I� /J <br />-ITN A1_r�L ray JS��/ E <br />DESRC�RIBE WONK AND SQUARE FOOTAGE 11OLVED <br />E �11Tmmm L <br />PROPOSED USE OF BUILDING / <br />R6QTmis / 4to <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 />CONTRACT RS L 18.2T R AND 296.200 WAC. <br />SIGNATUREOF ONT TOROF H iIZEDAGENT DATE fl- <br />x F.c. G � coo <br />It <br />APPLI ANip CITY BUSINESS LICENSE NO AND B SINE55 NAME <br />LEGAL RESCRIPTION OF PROPER SHOWN BIBLOWOR ATTACH FOUR COPIES) <br />� y��� <br />LOT 3.. BLOCK 714 ` F !Mc -ffififn <br />LAMD C"wy� �r 4AMN <br />1 <br />72 r, LY •�QE,�,r �0�171�1(r• <br />¢ <br />RECO OW IN YOL . 3 '1� 20 <br />7id�v.a-'�i VOL. <br />PROD <br />DD ESS <br />C <br />V <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 />ABC--A/HNDLG UNITS-H.P. <br />T- <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. IA E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />_ <br />_ <br />SHOWER <br />z <br />CLOTHES DRYERS <br />KITCHEN SINK B DISP <br />VENTILATION FANS NN4c.Z10N$ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />_ <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />-�.- <br />BACKFLOW PREV TERS <br />_ <br />GAS PIPING <br />ROOF DRAINS AINLEADERS <br />EXHAUST FAN <br />_ <br />SINK (SER E-BAR, ETC.) <br />SUB TOTAL $ <br />SUB TOTAL $ <br />_ <br />PERMIT 5 <br />PERMIT $ <br />TOTAL FEE S <br />TOTA-FEE $1 <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />PLAN CHE KNUMBLA <br />dAS <br />FEE <br />52 <br />RECEIPT NO <br />USE ZONE <br />CA <br />LOT AREA <br />VACANT SITE <br />h <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />Jq7 b <br />G'n�7 <br />Q� <br />THE OF CONTS ALLOWABLE <br />TYPE OF WNST ACTUAL <br />-jala� <br />NC NIAUTALUNa3 <br />PLUMBING <br />SIZE OF BLDG <br />lIS ),58 Saft. <br />NO OF STORIES <br />II Im"u.MF32S. <br />BASEMENT <br />MFCHANICAL <br />- <br />ADDITIONAL PLAN CHECK <br />000UPANCYLOAD FIRE SPRINKLERS REO D HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />OTHER <br />STAFF BUI'.OING SURCHARGE <br />tf �D <br />IN AXE BY <br />Ylrv� <br />r IS APPROVED BY <br />I 1 I <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL,1.2 <br />►tt vl0,0 <br />Fbf PPLIARlif# t/rT i AA r9.&Au/A./ <br />37.. <br />