Laserfiche WebLink
APPLICATIGA FOR CONSTRUCTBJN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 OL <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING $'SIGN <br />PROJECT ADDRESS: qL /2G{CGC ,_; � 4V L E( EPET i Gy/! 0&)3 <br />OWNER MAIL ADDRESS CITY ZIP P. IONE <br />,-,F- e,iL Co, py. box z/ltiy? sEA ,-l..E WL 9d20�p �L'Vi772-e,76s <br />TENANT MAIL ADDRESS CITY ZIP ' PI E <br />t K)EY ff_ rdH48i4'A I/Z3, I�uCGf-D, Fa✓6. <br />AACRITECTIRDESIGNEn MAIL ADDRESS CITY III, NONE <br />GENEN'< CONJTTRACTOR AIl <br />rU I� <br />MLCI!WCAL CONTRACTOR MAIL <br />11, r, vne >IAIL <br />cu r III' rNUNL <br />RLMBM'G CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />CONTRACT PRIyE OF WORK <br />�%, f / zz 7, 00 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK Am6 SQUARE FOOTAGE. INVOLVED <br />&f..� <br />CONTACT PERSON AND PHONE NO <br />1- <br />✓1�FGK�./ 00 1 1 A q,- AA- f A_Xl / Tj t. i /L'E'1L' F <br />.,[ <br />r L'%Z v (2 - 7 �/C' J tSjCC. ..Jv <br />I H REBY CERTIFY THAT 1 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 />WORK WILL BE COMPLIED 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 On LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION 0 I MADE AND I COMPLY WITH THE STATE <br />CONTRACT R L 18.27 AND 296.2 WAC. <br />X <br />ULfi ! YLEN g I �L: ✓ C/j L-c?O 5 G'= <br />PROPOSED USE a BUILDNO <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO CORES) <br />LOT BLOCK OF <br />PA7TAx LD. NUMBER <br />5 Z _ n'z <br />CONBTRIIC LOAN I FNDER. ADORE SS. TELEPHONE NUMBER <br />6L/ <br />SONAT DATE <br />cir4usylEss LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C-ARWOLG UNITS <br />r <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS <br />; <br />LAVATORY [WASH BASIN) <br />I <br />HEAT PUMP <br />r <br />SHOWER <br />' <br />UNIT HEATERS <br />' <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />i <br />DISHWASHER <br />' <br />r-, <br />FLANGE HOOD <br />' <br />LAUNDRY TRAY <br />; <br />'r <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />-� <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />; <br />SINK (SERVICE - BAR, ETC.) <br />r <br />GAS PIPING <br />EXHAUST FAN <br />) <br />1 <br />T <br />SUB TOTAL f <br />SUB TOTAL f <br />PERMIT f <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK <br />REARSFTBACK Fr..-,SSTBACK <br />I`I AN CIIECK NUMOFI. <br />FEE <br />nFCFIPT NO <br />USEZONE <br />lOTAREAA VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />DYES O NO <br />/ <br />_ <br />(- .31 <br />BUILLIING <br />HEIGHT LIMITATIOy <br />NO OF DWELLING <br />SIZE OF BLOWTI <br />, <br />Z" <br />UNITS <br />PLUMBING <br />_ <br />OCCUPANCY <br />NO D 11011111 <br />OCCUPANT LOAD <br />BASEMENT <br />MECIIANIC.AI <br />GROUP <br />I <br />OYES ❑ NO <br />ADOIIIONAI. PIANCHFCK <br />, <br />FIRE SPRINKLER REO'0 <br />RFASON <br />0714EA <br />FIRE ALARM RED'D <br />REASON <br />— <br />STATEBUILDINGSIInCHAnGF <br />TYPE OF f.ONST <br />PLANS APPROVE IT pv <br />CTIY OF EVERETT <br />rORIIr, WOIRES <br />y4f I <br />LOCAL SALES <br />CODE IS 3105 <br />TOTAL <br />DATE ee�TAX <br />7 <br />