Laserfiche WebLink
APPLICATIC 1 FOR CONSTRUCT )N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT I HEATING SYSTEM: X GAS J ELECTRIC U <br /> 259.8810 <br /> DEMOLITION COMBINATION K BUILDING KMECHANICAL KPLUMBING SIGN <br /> OWNER MAIL ADDRESS CITY ZIP PEgNE <br /> �jAlNls r4 . MIJ�PA`( � Zx ��ti P.rmIrLL aY��f l w� �rtil �la� 1� g2z -�aa� <br /> TENANT MAR AOOR 65 CITY ZIP PHONE <br /> hfhur <br /> ARCHITECT OR DESIGNER MAIL ADDRESS Clry ZIP PHONE <br /> GENERAL CONTRACTOR MAILADDRESS CITY ZIP PHONE STATE LICENSE <br /> 11:4W <br /> MECHANICAL CONTRACTOR MAR ADDRESS Clry ZIP PHONE STATE LICENSE <br /> WL A2tY '_A3_l_ftML, 1144-7 170TM NC Klfrc� ?Nv33 f3Z� 1a�8 I?cLAfltmm'?�AJ {Sl � <br /> PLUMBING CONTRACTOR MAR ADDRESS CITY ZIP PHONE STATE LICENSE <br /> lJNrrcp RiTnPnAY1 nlny 11,01^ A1Cdif 4101, 'IP07z. '1L/,5•7-1W ,uI * 14g FF <br /> CLASS OF WORK I Z <br /> �(NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PERSON AND PHONE NO. <br /> CONTRACT PRICE OF WORK T -5'2 <br /> OFSCRIBE WORK AND SQUARE FOOTAGE INVOLVED �f,V <br /> 050 � Z; ij A1Qv4C <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> `{ _ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESSC�RIIPTON OF PROPERTY(SHOWN DELOWOR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LOT of euR>L. M IU, NT A WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN 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 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 WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> it 21oSo 58�5� S� z //. / ,..at .IAO IV 1113 _ <br /> PROJECT ADDRESS SGNATUAE DATF <br /> nry M"NEsso:rva No <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) Z AC-AIHNOLG UNITS-H.P. J <br /> BATHTUB __ ; FORCED AIR SYSTEMS-BT. <br /> . U. ALM E,A. <br /> _5 LAVATORY(WASH BASIN) _ UNIT HEATERS-BTU. M ; <br /> 7- SHOWER CLOTHES DRYERS , <br /> I KITCHEN SINK A DISP _ VENTILATION FAN ' <br /> I DISHWASHER - { <br /> 7 , RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER 71 WOOD STOVE <br /> URINAL METAL FIREPLACE A CHIMNEY T <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ✓ GAS PIPING ' <br /> ROOF DRAINS-RAINLEADERS I EXHAUST FAN , <br /> SINK(SERVICE-BAR,ETC.) , <br /> , <br /> _ _SUBTOTAL $ SUBTOTAL $ ' <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: r�(D -73 <br /> ff10NT SETBACK NEAR SETBACK SIDE SETBACK PLAN CHECK NUMBER FEE f— REC IPT NO <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> S 7_12350. BUILDING (o( 753 <br /> TINOWABLE TYPE{OF•�CONST.ACTUAL <br /> DCCu14W:r MdOWFIIuq WnS <br /> ir� T/ �1 b1• PLUMBING <br /> KBE. • , <br /> SIZE OF BLDG NO OF STORIES BASEMENT MECHANICAL <br /> SW9 SF t <br /> 9P5 �r 6A9 Z /A/0 <br /> OLICUPANC j LOAD FIRE SPRNKLERS REOD HEIGHT IMITATIO1N ADDITIONAL PLAN CHECK <br /> y, <br /> _ A/v GS sPRxmceTr — <br /> REAl:ON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS <br /> J N LOCAL SALES <br /> 3 y �3 TAX CODE IS 3105 TOTAL p 9 ;47 <br />