Laserfiche WebLink
APPLICATI� FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259•8810 <br />❑ DEMOLITION fl COMBINATION f_l BUILDING f_1 MECHANICAL I i PLUMBING ' i SIGN <br />ONRlER MAILADDRE55 CITY 21P PNONE <br />Ror�eline Ronser 3906 Rucker Ave Everett WA 98201 725-4224 <br />TENANT MRIL�DDRE55 CITV 21P PHON[ <br />DESIGNER MRIL <br />ZIP PHONE <br />GENERAGONTR�CTOR M�IL�ODRESS CITY ZIP PHONE SiRTELICEN5E1 <br />MECWWILALCONiR�GTOR MML�DDflE55 <br />PLUMBINGCONTRACTOR MAILRDDRE55 <br />LONTR�GT PRICE OF WORK <br />DESCRIBE WdiK �ND SOUARE FOOTAGE iNVOLVED <br />Add bedroome in basement fi attic <br />PROPOSED lISE OF BUILDING <br />LEGAI DESCHIPTION OF PROPERTV I�NOWN BELOW OR ATT0.CM TWO COPIES� <br />ioT 66.67 BIOCK � OF Street Ruck <br />PARCEITA%�.D.NUI.IBER <br />5788-005-006-0007 <br />CONSTflUCT10N LOAN LENDEP. ADDRE55, <br />PROJECT ADDRESS <br />WATER CLOSET <br />enn�rue <br />DISP <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />FOR OFFICE USE ONLY: <br />�1 <br />n <br />INTAKE BV <br />��� <br />LOTARER <br />(,�/.SZ� <br />N0. OF STORIES <br />� <br />FIRE SPRINKLER51 <br />N� <br />FIRE ALA M REOD <br />�� v <br />PlANS APPROVED BY <br />DATE <br />)TAL $ <br />T $ <br />FEE 5 <br />VACPNT SITE <br />i ! VES �NO <br />d:LUPANLY NO O�PHFLlI44Ni'15 <br />BRSEME4T <br />� YES ❑ NO <br />11EIGHT LIMITATION <br />O <br />TAX CODE IS 3705 <br />21P FNONE <br />21P PHONE <br />CONi�CT PERSON ANO PMONE NO. <br />ST�TE LICENSE I <br />LIGENSE � <br />i HEREBY CERTIFY THAT I HAVE PEAD AND E%AMINED 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 AUTHQRIZED BY THE <br />OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTfiACTORS LAW 1827 FCW AND 296200 WAC. <br />x �� l°-u-93 <br />$pN�LUFF. D�IE <br />A/C�A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />AANGEHOOD <br />HEAT PUti <br />GAS PIPI� <br />EXHAUST <br />PIAN, C/H�ECe? NUM�[R <br />7'(/`1�l'� <br />PLUMBING <br />MECNANICAL <br />ADOITIONAL PLAN CHECH <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />u <br />TOTAL S <br />NIT $ <br />1L FEE S <br />7 <br />N <br />o� <br />