Laserfiche WebLink
APPLIGATI4��! FOR COIdSTRUCI .�N PER11AlT <br /> ClTY OF EVERETf• BUILDING DIVISIJN <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259•8610 <br /> p DEMOLITION rl COMDINATION f7 BUILQING ❑ MECHANICAL f� PLUMBING (-I SIGN <br /> PP.OJECT ADDRESS � �� � � <br /> !) CC���� �'`� /� /.ti� �����, ��� <br /> �O NER / / / MhILA�ORESS // CITY 21P �� PHONE <br /> �co y�in�-� /4�/.� ��/��✓� �v. �v��� G�v.'� �d�/ -D�IaS . <br /> TENAI.IT MAILAODF1E55 Cltt ZIP PHONE <br /> ARCNITECTOROFSIGNER MAILA�OR[55 GITY ZI° PMONE <br /> GF.NERALCONiR�CTOR MpILADOR[SS CRY ZIP PIIONE $TATELICENSEM <br /> MEC ANICAL CONiRACTp� MAI��DORE55 I (;ITY ZIP PHONE STATE LICENSE M <br /> �11 e lLvr- V'll�.�ti��.�A /-/� /l� <br /> PlUM81NGCONTR4CTOfi MAILA ESS CI7Y 21P PHONE $TATELICENSEM <br /> CONTRACT PRICE OF WOfiN <br /> HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br /> �ESCFIBE WORN AND SOUARE FOOTAGE INVOLVED CONTACT PERSCN AN�PHpNE N0. <br /> � �� i 1 <br /> �n .� .fy(�l � �/r,�r -'�� �� ���L�- 7�/� <br /> �/ // � I HEREl3Y CERTIFY THAT�I HAVE READ AND EXAIdINED THIS <br /> �f�Y �✓��'c"`_� <br /> PFOPOSED USE OF�UILDING APPCCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> I PRrVISIONS OF LAWS AND ORDINANCES GOVERNING TH:S TYPE OF . <br /> WORK WILL BE COMPIIED WITH WHETHEF SPECIFIED HEREIN OR <br /> IEGALDESCflIPTIONOFPROPEANISHOWNOELOWORl.TfACHT140GOPIE$� NOT. THE GF�ANTING OF A PERMIT DDES NOT PRESUME TO GIVE <br /> �or o�ocK o�= AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATWG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF fH15 PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS IAADE AND I COMPLY WIiH THE STATE <br /> PARCEITAX I.D.NUMBER CONTRACTORS lAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTIONLOPNLEN�Efl,AD�flESS.TELEPHONE Nl1M0ER X <br /> SIGNFTUFE DATE <br /> CIN BUSMGSS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. l'YVE OF FIXTURE OR ITEM FEE <br /> � WATER CLOSET(TOILET) � A/C—N'-�YDLG UNITS—H.P. T <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) �— HEAT PUA1P � <br /> SHOWER � UNIT HEATeRS—B.T,U. M � <br /> KITCHEN SINK&DISP ; CLOTHES DRYEfiS I <br /> OISHWASHER � VENTILATION FAN <br /> I.AUNDRY TRAV ; RANGE HOOD � <br /> CLOTHES WASHER � WATERfiEATER � <br /> URINAL � WOOD STOVE ' <br /> DRINKING FOUNTAIN ; METAL FIREPIACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) �— <br /> BACKFLOW PREVENTERS ; GAS FIFlEPLACE ; <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ; GAS PIPING ; � <br /> � EXHAUSTFAN � <br /> � � <br /> �. � � <br /> � � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL $ ; <br /> PERMIT S � PERMIT S � <br /> TOTALFtE S � TOTALFEE S ' � <br /> I - <br /> FOR OFFICE USE ONLY: <br /> FFi0kT5ET0AGK RURSETBACK SIUESEiOACK PLANCfIECK(:,UMOEF FEE RECEIPTNJ. <br /> /� j/ : <br /> "]/i `I J <br /> usezorv[ LpTAREA vncnNisite FEES VALUATION FEE <br /> _ nves n so om�oiNc I <br /> HEIGHT LIMITATION NO.OF DY/ELIING 512E OF OLDGRI. � <br /> UNI�S P�Uh1pING i <br /> OCCUPANCY NO OFSi0PiE5 OCCUPAN�LOAD BASEN�ENT I/EGHANICAL � <br /> GROUP <br /> ❑YES ❑ NO i <br /> FIRE ALARM REO'D REASON ADDITIONAI PI.AN CHECN � ���� <br /> /� i= <br /> OTHEq \. .�,7/��i�l/i.-� L/!� ij�'� <br /> FIRE SPRINKLER REO'D REASON ' � <br /> STATE DUILOING SURCHMGE i <br /> i <br /> rvaeoreor+sr ri.nNsnnvpoveoov CITYOFEVERETT ruoucwoans � <br /> ',,V�'13� LOCAL SALES � <br /> omE ; Z� ! 7AX CODE IS 3105 TOTAL i�� I(n � <br /> i d_ — � <br />