Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
APPLICATIO�irl FOR CONSTRUCTi�bN PERMIT <br />�� E���� everett <br />cin oF � <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />, DEMOI.ITION ❑ COMBINATION jd BUILDING '-; MECHANICAL �' '�UMBING ❑ SIGN <br />NTlER MRI�ADORESS Cltt ZIP PNONE <br />�i� $�,�[dFes �n '13cx 9� �uKicTc� �/�7_�S 3y�_��ic� <br />TENRNT M�ILADDRE55 Cltt Z'P PHONE <br />ARCHITECTOROESIGNER MAILAD7f1E55 CITY IIP PHONE <br />GENER�LCONTRAC70R MMI�ODRE55 CITV ZIP PHONE LI:ENSE1 <br />MELHANIC�LCONTRAGTOR M�ILAODPI58 CITV ZIP PNONE IICENSEI <br />PLUMBINGCONTRAGTOR MAILADDRESS CITV ZIP PHONE U;ENSE� <br />i <br />� GlA$SOFWORK <br />� NEW C ADDITION ❑ AITERATION l=i REPAIR l-1 DEMOLITION ❑ WOODSTOVElFRPLINSERT [ BUILDIN3RELOCATION <br />ItN�NiIMPNOVEMENTONINTEPIOR <br />f lOT e26 BIOGK OF <br />�. N0. TVPE OF flXTURE <br />WATER CLOSET ITOILEn <br />j earHrue <br />' ` LAVATORY (WASh 3ASIN) <br />. SHOWER <br />� KITCHEN SINK 8 DISP <br />n <br />TRAY <br />WASHER <br />FRON*SETBA4 RURSETE <br />�'".�.• 2s'� <br />USE Z011fi LOT �RE� <br />.�,5 �_�° <br />iYPEOLCONST./iLIOWABIE iYPEOftON <br />OCCUPANGVLOAD <br />� REASO FOFiSPRINNLERS <br />�PPLICATION �CC. BY <br />CONT�GT PERSON AND PMONE NO. <br />I HEREBV CERTIFY THAT I HAVE READ AND EJfAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS iYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR I.00AL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEHFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTURS LAW 18,27 RCW AND 296.200 WAC. <br />SIGI•�TUREOFC9NTRAGTORORAUTHORREOAGENI DFTE <br />X <br />�PPLICANTS flfY BUSINESS IICENSE NO. rW D BUSINE55 NAME <br />NO. V• ` TYPE OF EUUIPMENT <br />� NC—A/HNDLG UNIT�H.P. <br />�' FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—A.T.U. M <br />— CLOTHES ORYERS <br />� VENTILAT�ON FA� <br />! RANGEHOOD <br />PERMIT $ —i— <br />TOTAL FEE $ � <br />'K� SIDE SETBRGK� � <br />; ? <br />VAC�NT SITE <br />_r YES Cl NO <br />hCiUAL acurr,xcr rropowFwHcuNns <br />- wi <br />17:z 1 <br />OF STORIES <br />� �I YES j( NO <br />PIRGSPRNKLEPSREO'0 HEIGHTLIMITpT10N <br />� 1 VES .7: NO if1. � <br />PLAhSAPPPOVEDBV <br />�� <br />�'��� 1 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE iS 3105 <br />'�1 i � c <br />?+� f�' <br />f:3 <br />SUB TOTAL $ — <br />PERMIT $ � <br />TOTALFEE $ <br />PLANCHEC NUM��C FEE�,.,'��_/� RECEIPTNO. � <br />J/ \ �, �-, J L <br />U �� o/ <br />FEES VALUATION FEE <br />BUIl01NG/�{'yG��C "�'�.� i> 'L i G <br />��_ <br />PLUMAING y Si�` �i'� <br />MECHANICAL ' � � } � <br />OTHE %� <br />STATE B ILDMG SURCHARGE <br />STA7E ENERGV SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />� i�'��-u �e : <br />