Laserfiche WebLink
APPLICATI�..�1 FOR CONSTRUCT.ON PERMET <br />everett <br />�. E..�,.�� � <br />an oF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />,7 DEMOUTION iJ COMBINATION ❑ BUILDING C MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWMER n MAILAOORE55 CITV 2iP PIqNE � <br />TEN�NT M�il ADDPESS GtY 21P PMONE <br />ARCMITECTQlDES'('iNER MAIL�DDRE55 LIiV 21P PNONE <br />GENERM CONTR�CTOR MML �ODRE55 CITY 21P PHONE IICENSE t <br />MECHANIC/�L CONTP:CTOR <br />RU4�M0 CONTRI1CTIXi <br />MAIL I1D�RE55 <br />M�R ADDRES$ <br />❑ NEW ❑ ADDITION ❑ ALTERATION <br />TENANTIMPROVEMENTORINiERq1iREMppELONLY <br />DESL111lE MIOPK <br />t:_:.�..+.i.n:�.� <br />CITV <br />❑ REPAIR O DEMOLITION <br />LEW�L OESGRIPTION OF PROPEfITY (SNONTI BELOW QA �1'TACN FW A COPIES� <br />�or,� S9� ��? e�ocK _ fi 7 L oF �✓C—aC�Tf <br />SHOWER <br />KITCHEN <br />CLOTHES WA: <br />URINAL <br />DRINKING FOI <br />FLOOR DiiAIN <br />BACKFLOW PI <br />ROOF DRAINS <br />SINK (SERVICI <br />"r10Nf SEiB�CK <br />15E ZONE <br />REIIRSETBACK � SIDESETBACK <br />LOT �REA <br />YPf OF CON57. AIIOWABIE I ME Oi CONS? �CTlll�l <br />iZE OF BIDG. <br />GCUPANCYLOAD <br />EASON FOR SPRINRLERS <br />'PLK�TION �CG. BY <br />NO.OF STOFIES <br />F19E SPRNNlERS RCOD <br />❑ YES G NO <br />PUNS �PPROVED BV <br />FEE <br />FHONE LICENSE � <br />ULENSE I <br />WOODSTOVE/FRPL INSERT ❑ BUILDING RELIX.ATION <br />CONT�CT PERSON �ND PHONE N0. <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES N9T PRESUME TO OIVE <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 AUTHORRED BV 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 296200 WAC. <br />S�6IUTUFEO�CONTRALid10RAU1HOPIZED�GENT D�TE <br />X ��/�,...� /_ /� <br />•�� <br />HEAT <br />GASI <br />PIANGHECKNUEIBER � FEE <br />v�C/�NT S17E FEES <br />❑ YES ❑ NO BUILDING <br />axun�xcr xoaonnuxcw�n <br />L9WP PIUMBING <br />BASEAIENT AIECHANICAL <br />❑ ves ❑ N� <br />HEIGMTIIMITAiION OTHER <br />STATE BUILOING SURCHaFGE <br />STATEENERGVSURCHARGE <br />CITY OF EVERETT PUBLIC WORNS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />NIJAE <br />SUB TOTAL E � <br />PERMIT 5 � <br />TOTALFEE S � <br />RECEIPT N0. <br />VALUATICN FEE <br />i <br />i <br />I <br />� <br />i <br />I 1 <br />� <br />