Laserfiche WebLink
APPLICKTION FOR CONSTRUCTION <br />PERMIT <br />theEftrgrean <br />CITY OF <br />everett everett <br />BUILDING DEPARTMENT <br />259-8610 TO BE COMPLETED IN INK - PLEASE PRINT <br />CITY TIP PIIONE <br />OWNER MAIL ADDRESS I _ ' ^ ^ ,v n.fA _ 06.110. <br />SaYNF� <br />CITY <br />21P <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAILAODRESS <br />YYY1 <br />CITY <br />21P <br />PHONE <br />LICENSE e <br />GENERAL CONTRACTOR <br />MAIL ADOR'_55 <br />Th� <br />21P <br />FHONE <br />LICENSE• <br />MELHANICALCONIRACTOR <br />MAIL ADDRESS <br />CITY <br />�— <br />CITy <br />ZIP <br />PHONE <br />LICENSE <br />PWMETNOCONTRACIOR <br />MAIL ADDRESS <br />ml _ M .,I.c YUPiERPT. INSERT ❑ BUILDING RELOCAT ION <br />❑ NEW ❑ ADDITION LJ ALTERATION LJ REPAIR II> <br />CONGCi PERSON AND PADRE NO <br />IENANTIMPROVEMENI OR INTERIOR REMODEL ONLY <br />n� <br />CONTRACT PRICE Or WORK <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />THIS APPLICATION AND <br />I HEREBY CERT IFY THAT I HAVE READ AND EXAMINED <br />PRO BED USE OF uILOING <br />TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />fT� <br />KNOW THE SAME TO BE <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />NG OF A PERMIT DOES NOT <br />SPECIFIED HEREIN OR VII0LATEOR <br />--Y PROPERTY ISNOWN BELOW OR ATTACH FOUfl COPIE51 <br />LEGA OEBCRIPTION OF <br />CAINCEL THE PROVISIONS OF <br />PRESU1ME TO GIVE UTHORITY TO VER <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER <br />LOT BLGCK OF <br />FOHMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />3p��Y�A <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAC. <br />SIGN0.TMEOr CONI�aAGTOJJJRIZEO AGENT DALE <br />APPLEANT S ZIT Y BUSINESS LICENSE NO AND BUSINESS NAME <br />PROJEr,T ADDRESS <br />v <br />MECHANICAL <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A/C — A/HNDLG UNITS —H.P. <br />WATER CLOSET 'TOILET) <br />FORCED AIR SYSTEMS— B.T.U. M EA <br />_ <br />BATHTUB <br />— <br />- <br />--- <br />UNIT HEATERS— B.T.U. M <br />_ <br />LAVATORY (WASH BASINI <br />— <br />CLOTHES DRYERS <br />.— <br />SHOWER <br />— <br />VENTILATION FAN <br />KITCHEN SINK& DISP. <br />DISHWASHER <br />_ <br />_ <br />RANGE HOOD <br />WATER HEATER <br />LAUNDRY TRAY <br />_ — <br />— <br />WOOD STOVE <br />— <br />CLOTHES WASHER <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />— <br />FIREPLACE INSERT <br />— <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GASPIPING <br />— <br />— <br />BACKFLOW PREVENTERS <br />_ <br />gOOF DRAINS— RAINLEADERS <br />EXHAUST FAN <br />— <br />SINK I' -SVICE — BAR, ETC) <br />& — <br />SUBTOTAL <br />IIISUBTOTAL <br />& <br />PERMIT <br />P <br />& <br />PERMIT _ <br />TOTAL FEE & <br />TOTAL FEE <br />REAR SETBACK <br />& <br />SIDE SETBACK <br />PLAN CHECK NUMBER FEE RECEIPT NO. <br />FRONT SETBACK <br />USEZONE <br />LOTAREA <br />VACANTSIII <br />FEES <br />VALUATION <br />FEE <br />❑ YES IT NO <br />BUILDING <br />----'-- <br />T'PE OF CONSi. <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />----- <br />ALLOWABLEIACIUAL <br />PLUMBING <br />SIZE OF BLDG <br />NO. OF STORIES <br />BSMT <br />ocD LOAD <br />MECHANICAL <br />IT Y <br />OTHER <br />O N <br />HEIGIIILIMITAIION <br />STATE BUILDING SURCHARGE <br />FIRE SFRINKLERS REOUIRED uYES ONO <br />STATE ENERGY SURCHARGE <br />PUBLICWORKS <br />APPLICATION ACC. BY PLANS A: PR BY <br />TOTAL <br />M <br />