Laserfiche WebLink
APPLICATIL.�1 FOR CONSTRUC'�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERE �� �8201 • 259-8810 <br />. <br />❑ DEMQUTION Jkf COMBINATIQN rl BUILDING I ECHANICAL fl PLUMBING CI SIGN <br />PROJECT ADDRESS <br />E <br />/DD�/ - 5�,�� <br />MNL <br />�c,rv 7 <br />�de�el`7_' <br />e� <br />zir rHONe <br />p'�ao.3 ��o/ � .�f'-�/7�'r <br />p.9-��vEs�6.��o��w,�� ��e�e.r�` ��aoi ao� �s's-a�� 9 <br />ARCHITECTORUESIGNER MAILAOORESS--yf CITY ZIP PHONE <br />GytE ��<R�.Y /�e�B,�x a��6 �'d��e� g�a� a��� - a.�=y7� <br />GENEHALCONTR�C70R MAIL40�RE55 CILV ZIP PHON[ STATELICENSE� <br />�urwer ��au� <br />MECNANICAL CONTR�CTOR MAIL AO�RESS CITV ZIP PHONE STATE LICENSE � <br />PWMBINGGONTRqCTOR MAILAO�PESS CIfY ZIP PHONE STATELICENSEN <br />�J / i /� i Q , <br />OF WORY <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />USE <br />LEGAL OESCRIPTION OF PPOPE�ITPVSIlC1NM BELOW OR ATfACH <br />\ ��-�-- <br />LOT � BLOCN �- <br />Sf%ry- �C�y'� d/-9S� <br />PARCELTAXI.D.Nt1MBER <br />CONSTRUCTION LOAN LENOER. ADDRESS. TELEPHONE NUMAER <br />NO. TYPE OF FI7(TURE OR ITEM <br />WATER CLOSET (TOILET) // <br />BATHTUB // <br />LAVATORY (WASH BASIN) // <br />SHOWER <br />�i K�TCHEN SINK & DISP — <br />LAUNDRYTRAY <br />CLOTHES WASHER - <br />URINAL <br />DRINK�NG FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />RINK/RFRVICF-RAp FTf <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK RGAR SETBACK <br />� _ / � � <br />USE ZONE <br />2- Z' <br />HEIGHT LIMIiATION <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />LOT AREA <br />; �. .sb o <br />NO OF DWELLING <br />UNITS � <br />3 'Z <br />.ARM REO'0 REASON <br />N� <br />°RINKLER REQ'0 REASON <br />- �J <br />S5' z1:�`I <br />FEE <br />����� <br />S <br />5 <br />SIUE SETBALH <br />S� <br />V�C�Ni SIiE <br />ca�+�es n No <br />)�DG�Li� t <br />S <br />IOA�/� I B45EMENi � <br />y��r/ fl YES i%NO <br />PIANSAPanqvEpor CITYOFEVERETT <br />�JH LOCAL SALES <br />onre 11 /1 Y> ��'1`i' T�IX CODE IS 3105 <br />SYSTEM: ❑ GAS j7�'ELECTRIC ❑ <br />6�'9 <br />I HEREBY CERTIFV THAT I I1AVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. AlL <br />PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED Wll'H WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUI�IE TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />UTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTIJN. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RGW AND 296.200 WAC. <br />I AT E � /� / //�� <br />CI BI151NESSLICENSENO. <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />A/C — A/HNDLG UNITS — H.P. � <br />FORCEDAIRSYSTEMS—B.T.U. M E.A. ; <br />HEAT PUMP i <br />UNIT HEATERS �— B.T.U. M ' <br />�I CLOTHES DRYERS � <br />RANGEH60D <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE <br />FIREPLACE INSER'� <br />GAS FIREPLACE <br />GAS PIPIIJG <br />EXHAUST FAN <br />SUB TOTAL $ '; <br />PERMIT S � <br />TOTAL FEE $ !-- <br />PLAN CIIECK NUMOEP I FEE <br />ouuoinc "Liz �vw U ' ` I _ <br />i <br />PLUN.BING � <br />' <br />MECHANICAL �j <br />� <br />AOOITIONALPLANCHECK � �2 <br />oT�,EN � i �i �� 2 .� ! <br />SiATE BUIL0ING SUiiC11MGE l� � <br />PU�IIC YlURKS � �� � <br />TOTAL I I / J L�I �% <br />