Laserfiche WebLink
APPLICATILIA FOR CONSTRUCT ION PERMIT <br />CITY OF EVERETT • BUILDING, DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />11 DEMOLITION I I COMBINATION i j BUILDING Y NlFrHermrel I i CI Il\AQIAIC <br />PROJECT ADDRESS <br />OWNER MAIL ADDRESS rITY om <br />�u x F)Nn/F �i <br />S.S'o l✓ /7'i J <br />3 sn..S;- t= .� <br />c-7r <br />>aa c / <br />� <br />TENANT <br />MAIL ADDRESS <br />City <br />71P <br />PHONE <br />�-9 -.a � 0 3 <br />ARCIITECTOR DE°AGNER <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE. <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />MECHANICrAL CONTRACTOR <br />M1IAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE. LICENSE II <br />CONTRACT PRICE OF WOIIK <br />_ OO <br />— <br />HEATING SYSTEM: Ll GAS Cl ELECTRIC F_-I <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />I HEREBY CERTIFY THAT I 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 OR LOCAL LAW REGULATING CONSTRUC 1ION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TH-- <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Gi, {��9 <br />X✓�![.C/1/�P-Ci� _ a a _ y �. - <br />PROPOSED USE OF BUILDING <br />LEGAL DESCflIPTION OF PROPERTY l5110WN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK of <br />/�� -7 cJ <br />�- D / j- 6 CDq-w / , Z- <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />SIGNATURE DATE <br />CJ,il7/ S/ <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />_ <br />WATER CLOSET (TOILET) <br />I <br />AIC-A/HNDLG UNITS -- H.P. <br />�— <br />BATHTUB <br />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />, <br />SHOWER <br />' <br />UNIT HEATERS-B.T.U. M <br />KITCHEN SINK & DISP <br />; <br />CLOTHES DRYERS <br />; <br />DISHWASHER <br />I <br />VENTILATION FAN <br />—T <br />LAUNDRY TRAY <br />' <br />RANGE HOOD <br />' <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />~— <br />DRINKING FOUNTAIN <br />; <br />METAL FIREPLACE (WOOD BURNING) <br />; <br />FLOOR DRAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />I <br />BACKFLOW PREVENTERS <br />' <br />GAS FIREPLACE <br />' <br />SINK (SERVICE - BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />; <br />I <br />, <br />1 <br />SUB TOTAL $ <br />SUB TOTAL S <br />PERMIT S <br />I <br />PERMIT $ <br />/7 , <br />TOTAL FEE $ . <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REM SETBACK <br />SIDS SETBACK <br />PLAN CIIECN NULBGR <br />PGE <br />RECEIPT NO. <br />USEZONE <br />LOTAPEA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— <br />i <br />F1 YES fl NO <br />HEIGMT!IM;-ATION <br />NO OF DWELLING <br />SIZE OF BLOGIf I. <br />- <br />UNITS <br />PLUMBING <br />i ' <br />OCCUPANCY <br />1111 OF STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />i <br />❑YES n NO <br />ADDITIONAL PLAN CHECK <br />I <br />FIRE ALARM READ <br />REASON <br />OTHER <br />T <br />FIRE SPRINKLER RED <br />REASON <br />STATE BWLDING SURCHARGE <br />' <br />TYPE OF CONST <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />Puouc WORKS <br />�— <br />I <br />LOCAL SALES <br />TOTAL <br />DATE <br />TAX CODE IS 3106 <br />