Laserfiche WebLink
APPLICATIIiN FOR CONSTRUCTION PERMIT* <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />n DEMOLITION I 1 COMBINATION Fl BUILDING MECHANICAL PLUMBING Fl SIGN <br />PROJECT ADDRESS O t\ <br />GENEML 2T 711 'MA/IL ALOD/Rn/[SGS <br />CITY ZIP <br />PHONE <br />STATE LICENSE It <br />MECHANIC CONTRACTOR 1nILADORE55,C <br />CITY TIP <br />PHONE <br />STATE LICENSER <br />s�-,.z�l��C- ���n�3 <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CITY ZIP <br />PHONF <br />STATE LICENSE• <br />CONTRACT PRICE OP WORK <br />-1;7'In <br />HEATING SYSTEM: jKGAS !- ;ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <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 FNO ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIEC WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW PECULATING 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 />7y/ C <br />X / Y J LO%� / _ '' — <br />- <br />PROPOSED LICE OF BUILDING <br />LEGAL DESCRIPTION OF PFOPERTY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />SIGNATUFFE DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS - H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />_ <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />' <br />SHOWER <br />UNIT HEATERS-B.T.U. M <br />_ <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />I <br />CLOTHES WASHER <br />WATER HEATER <br />' <br />URINAL <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE - BAR, ETC.) <br />GAS RANGE <br />' <br />GAS PIPING <br />' <br />i <br />EXHAUST FAN <br />SUB TOTAL S <br />SUB TOTAL $ <br />PERMIT S <br />I <br />PERMIT S <br />I <br />TOTAL FEE S <br />' <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NIIMOER <br />FFF <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />I <br />FI YES ET NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF DLDGR I. <br />UNITS <br />PLUMBING <br />{ <br />OCCUPANCY NO OF STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />i <br />GROUP <br />I <br />❑VEB ❑ NO <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM REO'D <br />REASON <br />OTHER <br />I <br />i <br />I IRE SPRINKLER REO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />TYPE OF CONST <br />PLANS APPROVED BY CITY OF EVERETT <br />PUBLIC WORKS <br />! OCAL SALES <br />j <br />TAX CODE IS 3105 <br />TOTAL <br />' <br />DATE <br />