Laserfiche WebLink
-, <br /> APPLICATIG-.� FOR CONSTRUCT �N PERMIT <br /> Me Evergre�n everett <br /> CITY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLE/(SE PRINT <br /> ❑ DEMOLITION COMBINATION - BUILDING �MECHANICAL PLUMBING = SIGN <br /> OWNEfl �,J� , ` MAILqDDFESS CIT'V^ ` :.IP PHONE <br /> T�N�U,� D��LI�+O�A`A ADDRESS�O �lFll �� R��' /��7 96'Zo3 �y�S��Z� <br /> CITY 21P PHpNE <br /> AflCHITECT OP DESIGNER MAII ADDRESS CITV ZIP PHpNE <br /> GENERALCONTR�CTOR MAILAD9NESS dTY 21P FMONE LICENSEr <br /> MECHANICA'_GONTRACTOR MAILApOflESS CITY ZIP PMpNE LICENSEM <br /> �SAYr E <br /> PLUMBINGCONTRACTOF MAILADDRESS CIiY ZIP PHONE UCENSE• <br /> LlASS OF WORK <br /> �NEW ❑ ADDITION `_ ALTERATION ,� REPAIR C DEMOLITION :_: WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TENANT IMPFOVEMFNT OR INTERIOR R:MODEL`CNLY CONTACT PF.RSON AND PHONE NO. <br /> G <br /> CONTRACT?RICEOFWORN: ,rj��j �-� <br /> DESCRIBc WORK AND SW�PE FOOTAGE INVONED <br /> PROPOSED JSE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG/L�ESLRIPTIONOFPPOPERTY�SHOWNBEIOWORATTACHFOURCOPIES� PROVISIONSOFLAWSANDORDINFNCESGOVERNINGTHISTYPEOF <br /> �or BLOCK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> — NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMc TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOqMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <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 pCW AND 296.200 WAC. <br /> SIGNATURE OF CONTRAGTOR Od AUTHORI:FD AGENT OATE <br /> � - S,r.l��4�r. w 8 X 6/1� �, <br /> PFJJECTAODRE55 <br /> APPLICANTS LITY BUSIN�fi ICENSE NO.AN�BUSINESS NAME <br /> PLUMBING MECHANIGAL <br /> NO. TYPE OF FIXTURE OR ITEM � FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE'� � A��A/HNDLG UNIT�—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> _ LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M —�— <br /> _ SHOWER �/ CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP ' VENTIJIT:ON FqN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAV ' WATEF HEATER <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ; METAL FIREPLAGE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ' GAS PIPING — <br /> fi00F DRAINS—RAINLEADERS EXHAUST FAN —T— <br /> SINK(SERVICE—BAR,ETC.) <br /> � - <br /> � <br /> � <br /> SUB TOTAL $ ' SUB TOTAL $ rs'— <br /> � � <br /> PERMIT $ � PERMIT $ _ �g� =- <br /> TOTAL FEE $ ' TOTAL FEE $ -� <br /> FRUNTSETBACN REARSETBACe ���� <br /> SIDESETBACN PLANCHECKNUMBER FEE RECEIPTNO. <br /> use zoNe LOT AREA vncar:r s�re FEES VALUATI6N FEE <br /> Si YES �_, NO BUILDING � <br /> iVPEOFCONSi.AILOWABLE 7YPEOFCOHST.AGiUAL ottuvm[r xoorewEwxGuwis <br /> GHWP <br /> PLUMBING � <br /> SREOFBLOG. NO.OFSTORIES OASEMENT MECHANICAL � <br /> ��..: YES :=1 NO <br /> OCCUPANCYLOAD FIRESPRNNLERSREO'D MEIGHTLIMITATION OTHER i <br /> L i YES `. � NO <br /> STATE BUILDING SURCHARGE � <br /> REASON FOq SPRINKLERS � <br /> STATEENERGYSURCHARGE � <br /> APPLILATIJNAGC.BV PIANS APPROVED BY CITY OF EVEREIT PUBLIC WORKS i <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL � <br />