Laserfiche WebLink
APPLICATIC"� FOR CONSTRUC'6'''";N PiERMIT <br />TO BE COMPLETEU IN BLACK INK—PLEASE PRINT � <br />671LDING DEPARTMENT <br />259-8810 <br />; 1 DEMOLITION I I COMBINATION <br />OVMER �'�S V J MAIL ALtOFE55 <br />RoD21(��E 2 -,Soy �'�� r <br />TEN�NT MNLAppRE55 <br />ARGMIiECTOR�E5IGNER MAILAD�R[55 <br />GENFR�LCONTF�CTOR IdAILA0DRE5S <br />MECHANIC�LCONTRACTOR MAILADORE55 <br />PLU!ABINGCONiF4CTOF IdAIL�D�flE55 <br />Comm�.v rrti p��,,.�¢wc: Senvice <br />CONTRACT PRIGE OF WORK <br />� I,�i L3.63 <br />DESCRIpE WORK AND SOU4P[ FOOTAGE INVOLVE� <br />YLu��I. Ll _1N i�.. 21�–r11 <br />HEATING SYSTEfv1: J GAS fJ ELE�,TRIC J <br />w <br />PROPOSED USE OF BUILDING <br />LEWL DESCflIPT10N OF PROPERTV �SNOWN dELOW OR ATTACH TWO COPIES� <br />LOT BLOCK -- OF <br />PqRCELTAXID.NUMBEF <br />CONSTRt1CTI0N LOAN LEN�[R 4DDRE$$, TELEPHONE NUTAHER <br />PLUMBING <br />NO. TYPE OF FI%TURE OR I <br />I 4VATEHCLOSEi (TOILE�) <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />I SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DFINKING FOUNTAIN <br />� FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.1 <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CK REARSEiCACN <br />USE20NE LOTFREA <br />7YPEOFCI1115i NOAFSTORIEE <br />LOAD <br />REASON <br />INIAKP Nv <br />SU8 TOTAL $ <br />PERMIT S <br />TOTAL FEE 5 <br />FIRE SPRINKLERS FEO'D <br />FIqS q�pRM BE00 <br />PLANS APPROVEO BV <br />�ATE <br />I BUII.DING <br />CI:V <br />FEE <br />GITV <br />GITV <br />G <br />B <br />MECNANICAL <br />ZIP PHON[ <br />��v3 3y <br />ZV' PHONE <br />ZIF PHONE <br />ZIP <br />KPLUMBING I SIGN <br />PNONE SLIIELICENSEe <br />T�P PHONE STAT: I ICENSE d <br />Z�P PMONE STATELICENSEv <br />�.�*� 3i N,.,, STA�vwoaa �,i,A �'iuZq2 <br />]A6� bSL2�oo Cpw�w.��S�b'3o <br />CONTAGT PeRWF AND FHONE NO <br />V A <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 SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AU?HORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE UR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE OF CONSTRUCTION. THA� I AM AUTHORI2ED BY 1'HE <br />OWNER OF THIS PROPERTY TO PERFORM THE WCRK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1A27 RCW AND 296.200 WAC. <br />x--L�� �.l,v� l 1- !6 -G 3 <br />$:(iNlitUiif� �q�E <br />crtvnusmessuce�cn�o - — <br />MEL'HANICAL -- <br />NO. TYPE OF EDUIPMENT FEE <br />A�C—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNITHEATERS-6.T.U. M L <br />CLOTHES DHYERS , <br />VENTILATION FAN <br />RANGEHOOD T— <br />WATER HEAI'ER � <br />WOOD STOVE � <br />METAL FlREPLACE (WOOD BURMING) � <br />FIREPLACE INSERT � <br />HEAT PUMP T— <br />GAS PIPING <br />EXfiAUST FAN ; <br />— ----�--� ----- -----`__-- <br />SIOESET�ACK PLANGHE KNlIh1BE FEE <br />VACANTSITE � ES <br />��'�: YES � NO BUILDING <br />oCU;FaLCY rlaerC:;f!uSGU•:'d5 - <br />��a�J� PLU�dBING <br />BnSEn�EnT MECHANICAL <br />�,-: YES �-�� NO <br />HEIG�i uAaiT4noN �D[71TIONAI PLAN CHECK <br />O7HER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S —� <br />