Laserfiche WebLink
APP CATIC �1 FOR CONSTRUCT" 1N PERMIT � <br />�����,� � �I TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />ii <br />AUG 2 3 �99� HEATING SYSTEM• �GAS U ELECTRIC U_ <br />BUILDING DEPARTM�.NT....._ <br />. ..................... <br />259•�jt�y pF EVERETT <br />❑ DE�ET�p�Iks D�pt� COMBINATION I� BUILDING :7'V,MECHANICAL I I PLUMBWG �I SIGN <br />OW ER lARILADDPESS CITY ZIP PNONE <br />�ohn Ci1ct� `i��G �l�^ �lr SF tt��r�ui} 98">C•S' 3SS-S:5�1(� <br />TENANT MAILAODfiE55 CITY 21P P�10NE <br />AP.CHITECTOPDESIGNER MAILADLRESS CITY ZIP PMONE <br />GENERAI <br />MAIL <br />QTY ZIP PHONE STATE IICENSE 1 <br />21P <br />��� <br />ZIP <br />CHANICPLCONTRACTOR MAILADORESS GTY <br />S�r,�ek, l,hc� 116�30 � 14�'� Ai;i., U;� <br />A1AIL �ODPESS <br />CONTRACT P@ICE OF WORK <br />� 3��G <br />DESLAIBE WOflK ANO SOUARE FOOTAGE INVOIVED <br />PPOPOSEU USE OF BUILDIPIG <br />LEGAL DESCflIFT10N OF PROPEflTV �SHOWN BELO\4 Ofl ATTACH 1 WO COPIES) <br />LOT BLOCN OF <br />PARCELTA%I.D.NUM�ER <br />i0�1�3-1'CO -UC)I "pCJ('� 3-J <br />CONSTRUCTIONLOANLENDER,AODRESS,TELEPHONENUMBER <br />PROJECTADDRESS <br />NO. I TYPE OF FIXTURE <br />WATER <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ET( <br />FOR OFFICE USE ONLY: <br />USE ZONE <br />7YPE OF C0115I. <br />512E OF BLOG.. <br />OGCUPANCYLU�D <br />REASON <br />INTAKE BV <br />SUBIOTAL $ <br />PERMIT $ <br />TOTALFEE $ <br />LOt AFEA <br />NO.OF SiOFIES <br />FIBE SPRINNLERS REO'U <br />FIPE �LARM REO-D <br />PLANSAPPROVED9V <br />OATE <br />\ <br />CITV <br />CONTALT <br />PHONE STATE LICENSE A � <br />5.�3 `iv5y Scaccr�l' I <br />PHONE STATELICENSEM <br />e <br />NO. ./.�. C'�]J .0 <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 TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN 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 iAW 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 />rrseim <br />NO. TYPE OF EQUIPME <br />AIC—NHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DIaYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />M[TAL FIREPLACE (WOOD E <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SI�ESET84CK PLANCHECKNUMUER <br />� ��31<�_ <br />VACANT SITE FEES <br />n ves n No OUILDING <br />arurnncv xo.ormvcwucuuns <br />�P°0P pLUM�ING <br />DASEMENT MECHANICAL <br />❑ YES ❑ NO <br />HEIG4{7�IMITATION AD�ITIONALPLANCHECK <br />07HER <br />STATE BUILDING SURCHPFGE <br />CITY OF EVERETT PUBLIC WORNS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />E.A. <br />SUBTOIAL S <br />PERMIT 5 <br />TOTAL FEE S <br />HEGEIPi NO. <br />0 <br />�>C�;G C` <br />IS�C r <br />�C`C,c <br />n <br />�p <br />0 <br />� <br />�y <br />N <br />�N <br />[ <br />