Laserfiche WebLink
APPLICATILA FOR CONSTRUCT ,,vN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT <br />259.8810 <br />HEATING SYSTEM: Ll GAS *ELECTRIC U <br />i DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE _ <br />f�Av L_ �Mcc- 9ov6 7�a SE L- E4e�rr -3'f7- /.24.5 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Dt-u/'/-j <br />3a�=fw <br />3r_/cTtc 4rt. <br />4,Bo3L, <br />774/ <br />GENERA_ CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE STATE LICENSER <br />O w A-cTL <br />MEC4ANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE STATE LICENSE, <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />CLASS OF WORK <br />I NEW x ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />g <br />CONTRACT PRICE OF WORK <br />p <br />CONTACT PERSON AND PHONE NO <br />DESCRIBE WORK AND SQSUTARE FOOTAGE INVOLVED <br />PROPOSED USE OF BUILDING f E' <br />S' L-1) Y 0�77 <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 COMPLETED WITH WHETHER :- ECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE 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 RCW AND 296.200 WAC. <br />X <br />LEGAL DESCRIPTIONOF PROPERTY (SHOWN BELOWOR ATTACH FOUR COPIES) <br />LOT BLOCK of _ <br />/�}'7,7./�-C M{-c� <br />PROJCCT ADDRESS 4C <br />717' <br />_ <br />L <br />�1e-g- <br />SiaNArUnE DAIS, <br />CITY BUSINFSStKLNSENO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />f <br />BATHTUB _ <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />,3 <br />UNIT HEATERS—B.T.U. , M <br />SHOWER <br />I <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRYTRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />; <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUSTFAN <br />_ <br />SINK (SERVICE —BAR, ETC.) <br />_ <br />I <br />SUB TOTAL <br />$ <br />SUB TOTAL $ <br />PERMIT <br />$ <br />PERMIT $ <br />TOTALFEE <br />$1 <br />Ie- <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: iR e . va <br />FRONT SETBACK <br />2j=;,/ <br />REAR SETBACK <br />2.o <br />SIDE SETBACK <br />5' <br />PLAN CHECK NUMBER <br />3 -Ya G <br />FEE <br />1 /3'1 fr <br />RECEIPT NO <br />6 3o a y <br />USE ZONE <br />�- <br />LOTAREA <br />375� <br />VACANT SITE <br />NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />Zp 5 <br />d I oa <br />TYPE OF CENTS. ALLOWABLE <br />IT —Ai <br />TYPE OF CONST ACTUAL <br />� <br />UGGGPAVCI <br />GPWP <br />.� <br />I NO GFVAELLINGU41I1 <br />1 <br />PLUMBING <br />/ <br />SIZE OF BLDG. 4» <br />Sif <br />NO. OF STORIES <br />ZJfLVJv- APP <br />BASEMENT <br />Alpr <br />MECHANICALINU <br />ADDITIONAL PLAN CHECK <br />��OJ <br />OCCUPANCY LOAD FIRE SPRINKLERS RED HEIGHT LIMITATION <br />REASONFORSPRINKLERS <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />; <br />INTAKE BY <br />PLANS APPROVED BY <br />��� 3�z�1= <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br /><26 9S <br />