Laserfiche WebLink
APPLICAT' IN FOR CONSTRUC 'ION PERMIT <br /> TO BE COMPLETED IN BLACK INV.—PLEASE PRINT <br /> �Aslc &0 ; SYcAmage (CITY ►i ��J <br /> BUILDING :EPARTMENT HEATING SYSTEM: §GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> i DEMOLITION I COMBINATION CI BUILDING I I MECHANICAL i I PLUMBING 11 SIGN <br /> OWNER MAR ADDRESS CITY ZIP PHONE <br /> 4;eLec1- HmIL5, lu C 237 CM ST EVER-ETT, gRzo �j 7S 4- ►Sl) i <br /> IENANT MAIL ADDRESS <br /> CITY ZIP WANE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE -- <br /> GENERAL CONTRACTOR MAK ADDRESS CITY ZIP PHONE STATE LICENSE F <br /> 58ME AS 11,1VA - :F .ECHIIIAC-A1 <br /> MECHANICAL CONIRACI011 MAR ADDRESS CITY ZIP PHONE STATE LICENSE/ --- <br /> PLUMBWOCONTMCTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE 1 <br /> CONTRACT PACE OF WORK <br /> W <br /> �0 Q <br /> DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED ACT PERSON AND PHONE NO. <br /> z-�L <br /> s <br /> FP— <br /> PROPOSED <br /> ePROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AI.L <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY ISMUWN BELOW OR ATTACH TWO COPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT .41 BLOCK _ OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> HAnR 13 r=I D1UISIO N 4 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 WHICIT <br /> PARCEL TAIL I D NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT TORS LAZY 10.27 RCw 6ND 296.200 WALT. <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER blol <br /> PROJECT ADD ESS S, -I t — <br /> wn I <br /> /i LSU <br /> CH,MnNf9B lClN6f N0 <br /> PLUMBING //-7-f MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLCSET(TOILET) I AIC—AfHNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A, <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M <br /> SHOWER ' CLOTHES DRYERS '— <br /> KITCHEN SINK d DISP ; VENTILATION FAN <br /> DISHWASHER I I RANGE H0010 <br /> LAUNDRY TRAY ' WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> DRINKINU FOUNTAIN I FIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP <br /> BACKFLOW PREVENTERS ' GAS PIPING I <br /> ROOF DRAINS—RAINLEADERS I -EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) I <br /> I I <br /> 67 I <br /> I <br /> I <br /> SUB TOTAL f ; SUB TOTAL f <br /> PERMIT f I PERMIT f <br /> TOTAL FEE f ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> I PONT SETBACK REAR SEFFACE, / SIDE SET / <br /> PWIC/IECK NUMBER FEE RECEI <br /> .3�USE ZONE <br /> [OTAA A VACANI SITE FEES <br /> �_ IA3o ❑ YES ❑ NO VALUATION F E <br /> 1,17 Of COME NO OF STORIES BUILDING 5 _ <br /> rcnnun AoalNAurcu.n <br /> 0�'N _ .a" PLUMBING <br /> ISI �.Af S*• TIRE SPIIKIXlERS NEOD BASEMENT — ' <br /> 63 <br /> 440 S' AO ij ❑ YES NO MECHANICAL <br /> OCCUPANCr PAD FIRE ALARM REEED HEIGHT LIMITATION ADDITIGNAL PLAN CHECK <br /> ❑LASON OTHER 2 /�T1'�J� <br /> -- --F�l <br /> STATE BUILDING SURCHARGE ' <br /> INTAKE BY PLANS APPROVED BY CITYOF EVERETT <br /> J LOCAL SALES ���WORKS 2 <br /> DATE Zlei g3 TAX CODE IS 3105 TOTAL <br />