Laserfiche WebLink
. i <br /> APPLICATIC J FOR CONSTRUCT`�N PERMIT � ' <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT �.�-i�lrorr <br /> ��-- <br /> BUILDING DEPAkTMENT HEATING SYSTEM: ,GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> � DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> O,WNER MAIIAD�RESS CITY 7,IP PHONE ' <br /> �am�s �- ��J 42t5 SST*� r.�,�, SR.v�r�.� , ,JA 9g,Ic�� <br /> TENANT MAIL ADDRE55 CITV 21° PHONE <br /> ARCHITECTORDESIGNER MAILADDRE55 CITY ZIP PHONE <br /> GENERALCONTqACTOR MAILADDPESS CITV 21P PHONE STATELICENSEI <br /> AaBoT: 4-bmc� 85os Boz�� �.=a�2 �.k, PJozu��c,�.3�1 9So11 <br /> MECHANICALCONTRRCTOR MAILAOORE55 CITV ZIP PHONE STATE I EN$ N <br /> iR�-S�z� Pw,,�giti�, �J�. 134il.O �J,�. il��� ST. ��.cr�.aa?,�A ��r�-e�?-�a�'z <br /> PLUMBINGCONTRACTOR MAILADDRESC CIN ZIP PHONE SiATELICENSEu <br /> CLASS OF WOflK <br /> �C NEW I I ADDITION �� ! ALTERATION . REPAIR � � DEMOLITiON WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> p CONTACT PERSON AyD PHONE NO <br /> CONTflACTPRICEOFWORK � I 1 QOO STA� Yim/jaj gp(o (a43 383G I <br /> DESCFiBE WORK AND SOUARE FOOTAGE INVOLVED <br /> I�-r.v�� �Zio �F2E �..�r_�..�'zs <br /> PR POSEDUSEOFBUILOING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS ' � <br /> T71�"c.J'[c_a APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCPIPTIONOFPRpPEPTY�SNOWNBELOWORArACHFOUflCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT _ BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESU'�= TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIC ; OF ANY <br /> _ OTHER STATE OR LOCAL LAW REGULATING CONSTRUC� .N OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEL BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CONPIY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. , <br /> 1222�z 14� � s,E'. ��-n i..�1 x — W. � R-`l-R2 <br /> PFOJECTAD SS SiGrvnrUNE pprE <br /> ma�-c�2�iT� '�- '�-TSCoo <br /> c�.r eus�NEss uccnsE r,o <br /> PLUMBING MECHANICAL I <br /> N0. TYPE OF FIXTUHE OR ITEM FEE NO. TVPE OF EQUIPMENT FEE � <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. ; � <br /> BATHTUB ; FORCEDAIRSYSTEMS—B.T.U. M E.A. —�— I <br /> LAJATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; � <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINK&DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD '� <br /> LAUNDRY TRAY ' WATER HEATER � � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL � METAL FIREPLACE&CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFIOW PREVENTEflS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FA� <br /> SINK(SERVICE—BAR,ETC.) , <br /> � <br /> � <br /> � <br /> � <br /> SUB TOTAL 3 ' SUB TOTAL ^� <br /> PERMIT $ � PERMIT $ <br /> TOTAL FEE $ TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACN SIDESETBACK p�pN�JCMECKNUMBER FEE qECEIPTNO. <br /> \/ <br /> usezoue LOTAREA VACANTSITE FEES VALUATION FEE <br /> BUILDIN� � <br /> i <br /> TVPEOFCONTS.ALLOWABLE TYPEOfC011Si.ACiIIAL occu�<utv i3OCrowEuu:6urWs <br /> GPn c pLUMBING � <br /> J7.- ItifZ �- I !{�Z py i0 <br /> SRE OF BLDG. N0.OF STORIES BT EMENT i <br /> I���2 � MECHANICAL i <br /> 2 Y�> <br /> OCCOPANCVLOAD FIflESPRNNLER5RE0'D HEIGNTLIMITATION �PLANCHECK �+� `� <br /> �� Y�� SPRINKLER i3S <br /> 9EASON FOR SPPINNLEPS <br /> � <br /> oRr�INFNVG'Y� STA7E BUILDING SURCHARGE <br /> INTAKEBY PLANSAPPROVEIiBY CITYOfEVERETT PUBLICWOFiK$ � <br /> LOCAL SALES ' <br /> q (I �Z JM TAX COUE IS 3105 To'A� '�� � �� <br />