Laserfiche WebLink
APPLICATIo.N FOR CONSTRUCII, ON <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />DEMOLITION I I COMBINATION <br />1PROJECT ADDRESS <br />0 <br />\DWNER <br />FI BUILDING ! � MECHANICAL <br />PHONE <br />' PLUMBING f I SIGN <br />ARCHITECT OR DESIGNER MAIL ADDRESS GIN <br />zIP rHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY <br />} 21r PHONE STATE LICENSE. <br />MECHANICAL CONTRACTOR MAIL ADDRESS ..... YYSL--� 6' �''r �'>% • ��!/�� 2 '% y T 7 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY _ <br />ZIP PHONE STATE LICENSE A <br />DESCRIBE WORK ANU SOVARE FOOTAGE. INVOLVED <br />• •�......, o r o I cm: I I LxAA" I I ELECTRIC F1 <br />CON1ACi PERSON AND PVONE NO <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />PROFOSED USE OF BUI IN(: <br />.' 17 <br />ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF E PE!R ISHOWN BELOW OR ATTACH TWO COPIES) <br />LOT <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />BLOCK __— OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION 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 <br />WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />—�j <br />PARCEL TAXI D. NUMBER - <br />CONSTRUCTION LOAN LENDEF ADDRESS, TELEPHONE NUMBER <br />61GNAT T zz <br />DATE <br />CITY BUSINESS <br />LICENSE NO <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />MECHANICAL <br />D. <br />WATER CLOSET (TOILET) - <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />' <br />BATHTUB <br />A/C—A/HNDIG UNITS — H.P. <br />LAVATORY (WASH BASIN) <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />SHOWER <br />HEATPUMP <br />KITCHEN SINK 8 DISP <br />UNIT HEATERS—B.T.U. M <br />DISHWASHER <br />CLOTHES DRYERS <br />LAUNDRY TRAY <br />VENTILATION FAN <br />CLOTHES WASHER <br />RANGE HOOD <br />—�- <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />_ <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />' <br />BACKFLOW PREVENTERS <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />SINK (SERVICE — BAR, <br />GAS FIREPLACE <br />I <br />GAS RANGE <br />GAS PIPING <br />Q <br />EXHAUSTFAN <br />i <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />- <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />Pt AN CHIE/C/��jjN� ++§§�� <br />ff.E <br />RECEIPT <br />yC0(9i�D <br />NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />FI YES Fl NO <br />BUILDING <br />I <br />I <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLOGRI. <br />UNITS <br />PLUMBING <br />i <br />' <br />OCCUPANCY <br />GROUP <br />NO OF STOPoES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />I <br />El YES 11 NO <br />FIREALARM FEO'D <br />REASON <br />ADUI RONAL PLAN CHECK <br />i <br />TIRE SPP'WER REO'D <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />TYFE OF CONST <br />PLANS APPROVED By <br />---� <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TOTAL <br />I <br />_ <br />DATE TAX CODE IS 3105 <br />