Laserfiche WebLink
APPLICATIOI^'m*FOR CONSTRUCTICA PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTI/IENT HEATING SYSTEM: gGAS U ELECTRIC U <br /> 259.8810 IIIIYY����� <br /> ❑ DEMOLITION I I COMBINATION XBUILDING I IMECHANICAL PLUMBING SIGN <br /> OWNER HAIL ADDRESS CITY ZIP PHONE <br /> yvz� /sq/C, Al!,4/ /I/?bAF 32e o y' V At 7 !r Aq 3 "D 3 _ <br /> TENANT — MAIL ADDRESS CITY ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> azulu as 64 r <br /> G�"ERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> Q Ld u.S of ` t"- l'eaA( l `71i i1b7- <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHCNE STATE LIM,.7- <br /> CONTRACT <br /> FCONTRACT PRICE OF WORK -- <br /> DESCRIBE WORK AND SQUARE f0.0 TACE INVOLVED pf <br /> C i PERSON AND PHONEI+0 <br /> aJ c +a+ 337 d ?r, 2.,.Y i Lc.iu <br /> I HEREBY CEPTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> r OPOSED USE OF BUILDING � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> 1&_j-FCGEIt LC"- PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAy SCRIPTIONOF PPOPQyY ISHOWN BELOW OR ATTACH TWOCOPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT BLOCK OF �n� -�ny // NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> TYl(ytL�Q/?LW /�j't'. ems. OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> • .TGA •�, / OWNER OF THIS PFIOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> P CEL TAK I D.NUMBER CONTRACTORS LLW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENDER,ADDRESS.TELEPHONE NUMBER <br /> PROJECADDRESS _ DATE <br /> X T� <br /> .) ! v <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I A/C-ANHNDLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) , UNIT HEATERS-B.T.U. M ; <br /> I SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP 4f VENTILATION FAN <br /> DISHWASHER - I I RANGE HOOD _ <br /> LAUNDRY TRAY WATER HEATER <br /> _ CLOTHES WASHER WOOD STOVE ; <br /> URINAL _ ,�L METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN _ FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKi LOW PREVENTERS GAS PIPING ; <br /> ROOF DRAINS-RAINLEADERS IP 41 EXHAUST FAN <br /> SINK(SERVICE-BAR.ETC.) ; <br /> _ SUB TOTAL $ 1 SUB TOTAL $ <br /> PERMIT $ 1 PERMIT $ <br /> TOTAL FEE $ 1 TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SIDE SETBACYF PLAN CHECK NUMBER FEE RECEIPT NO <br /> Z /o' ':r . S D.3 3c? C5'�'? <br /> USE ZONE LOTAREA VACANT SITE FEES VALUATION FEE <br /> Z-S / `/ y 7/ M YES •f7 NO BUILDING <br /> TYPE OF CONST NO OFS 7 IES O[[uw.Ncr MI D'owfunM W�15 <br /> � �3 / PLUMBING <br /> SIS F.L FIRE SPRINKLERS REOD BASEMENT / D , 0 <br /> MV ✓YES NO MECHANICAL Q <br /> OCCUPANCY LOAD FIRE ALARM RED D HEIGHT LIMITATICq, ADDITIONAL PLAN CHECK <br /> REASON /1 A vg/ OTHER )4!�U�- b :00 <br /> STATE BUILDING SURCHARGE i Jo <br /> INTAKE BY PIANS APPRPPV D By CITY OF EVERETT PUBLIC WORKS <br /> :7P LOCAL SALES I dU <br /> DATES�p�gc f TAX CODE IS 3105 TOTAL <br />