Laserfiche WebLink
APPLICATIOd FOR CONSTRUC7.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />f 1 DEMOLITION COMBINATION BUILDING I MECHANICAL i I PLUMBING SIGN <br />PROJECT ADDRESS 10 r <br />OW'NE MAIL ADDRESS CITY ZIP PHONE <br />IEN. MAII//AAD�D �_.ESS <br />I A0/ <br />Cltt <br />ZIP <br />r11C6E <br />ARCH". TOR DESIGNER All ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR MAILADORE59 <br />CITY <br />ZIP <br />ONE <br />PITON[ <br />STATE LICENSE <br />AAA <br />NICAL CqRACTDR MAI <br />ADD S <br />1 <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE 0 <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />//%/nn <br />0 <br />1�/n <br />PHONE <br />��jE LICENSE <br />CONTRACT rRICEO ORK Y <br />HEATING SYSTEM: [-]GAS C ELECTRIC ❑ <br />DESORIBL 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 AND ORDINANCES GOVERNING THIS TYPE OF <br />PROPOSED USE OF BUILDING <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO RIVE <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK or <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 PER E WORK FOR WHICH <br />APPLICATION IS NO I C Y WITH THE STATE <br />CONTRACTORS W .2 2 DO WAC. <br />PARCEL TA%ID. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />G ATURE DATE <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C — AMNDLG UNITS — H.P. <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />T <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />' <br />SHOWER <br />UNIT HEATERS—B.T.U. M <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />' <br />I <br />LAUNDRY TRAY <br />LAUNDRY <br />RANGE FIOOD <br />__� <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL f-iREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />T— <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS RANGE <br />' <br />GAS PIPING <br />— <br />EXHAUSTFAN <br />SUBTOTAL $ <br />SUBTOTAL S <br />i <br />PERMIT S <br />I <br />PERMIT S <br />' <br />TOTAL FEE $ <br />' <br />TOTALFEE $ <br />run urrv.c uac vine_.. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />FEES <br />VALUATION <br />FEE <br />USEZDNE <br />LOT AREA <br />VACANT SITE <br />f]VES R NO <br />BUILDING <br />I _ <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDGq I. <br />PLUMBING <br />�T— <br />MECHANICAL <br />I <br />I <br />OCCUPANCY <br />NO OF STORIES <br />OCCUPANTLOAD <br />BASEMENT <br />GROUP <br />❑YES n NO <br />i <br />ADDITIONAL PLAN CHECK <br />TIME ALARM RED <br />REASON <br />OTHER <br />FIRE SPRINKLER REO'D <br />REASON <br />' <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TYPE OF OONST <br />PLANS APPROVED DY <br />CITY OF EVERETT <br />LOCAL SALES <br />I <br />CODE IS 3105 <br />TOTAL <br />' <br />DATETAX <br />