Laserfiche WebLink
0 <br />�-, � l��j3 <br />APPLICAT�aiN FOR CONSTRUC�r10N PERMIT <br />!M EHrproen everett <br />CIiV OF � � <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—P,L�ASE PRINT <br />❑ DEMOLITION ' I COMBINATION ❑ BUILDING �i MECHANICAL I 1 PLUMBING O SIGN <br />�tN�n/,-��� MI1P.IIDDRE55 CITY - ZIP PHONE <br />ARCNITECTOROESHiNER M�ILADDRE55 CILV ZIP PHONE <br />PLUAIBINOCONTR�CTOR M�IL�bORE55 GITY Zlv P11pryE UCENSE� �—/��'�� <br />❑ NEW rl ADDITION <br />TENANT <br />l■� <br />PROM�SEO USE OF BUROING /� ( �-(/'% <br />VT � � <br />LEOAL DESCRIPTKIN OF PROPERTY I�"�WN BELOW OR <br />l0T__ BIOCK _ OF _ <br />�i <br />' ROOF DR/ <br />iSINK (SER <br />� <br />' —. <br />FRONTSETBACK <br />USE IONE <br />ttPF Oi CONSi. ALLOWABIE <br />SIZE OF BlflO. <br />OCCUFPNCYLO�� <br />REASON FOR SPPINKlERS <br />�>PLICeT10N ALC. BY <br />i� <br />f l REPAIR I l DEMOLITION I I WOODSTOVFJFRPL INSERT [1 BUILDING REI.00ATION <br />FEE <br />CONTACi PERSON AND PMONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AVD CURRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN �H <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM! "'D ;iIVE <br />AUT�IORITY TO VIOLATE OR CANCEL THE PROVISIONS Jf ANY <br />OTHEfi STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOFi WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNAfUREOFCONiRqCTOROR�UT110Ri2E�AGFNT O�TE <br />l i�. <br />x—, :'L�'��i i F� iz -�.s - a� <br />APPLICANTSCITVBUSINP SLICENSENO OBUSINESSN�ME <br />HOOD <br />METAL FIREPL <br />FIREPLACEIN <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />I OF E�UIPN <br />UNITS—H.P. <br />QINCIISI:IX7 <br />SUB TOTAI $ ; SUB TOTAL <br />PERMIT $ � PERMIT <br />TOTAI FEE $ ' TO7AL FEE <br />RE�RSETBACK GIDESETBACK PLANCNECNNUMOEO FEE <br />L07RREA VACANTSITE FEES VALUATION <br />Ll YES ❑ NO BUILDING <br />1YPFOfGONSI.ACNAL aGnWo�v xoaownuncuxn9 _ _ <br />PLUMBING <br />NO.OFStORIES BnSEMENi MECHP��,ICAL <br />I I VES I�] NO <br />fIRESPRNNlEqSREOD HEIGHTLIMItAIION ��NER <br />LI VES I. 1 NO STATE OUILDING SURCHARGE <br />STATE ENERGV SIIHCHARGE <br />PUNS APPpOVEO BY CITY OF EVERETT PUBL�C WORhS <br />LOCAL SALES <br />TAl( CODE IS 3105 TOTAL <br />—{-- <br />s '� <br />$ � <br />RECEIPT N0. <br />FEF. <br />---T— <br />i <br />i <br />� <br />i <br />—�— <br />4'L��= <br />� <br />