Laserfiche WebLink
APPLICATION FOR CONSTRUCTION PERMIT <br /> rnP Eroryleen TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF <br /> everettI HEATING SYSTEM: ACAS JFLFCIRIC J_ <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> DEMOLITIONfC COMBINATION / BUILDING MECHANICAL _ PLUMBING SIGN <br /> °�r�p MMI ADDRESS CITY ZIP PHONE <br /> 1 T/V&wr— Tie �'. yDzohlal;) .kttzo; &<j `Pe /2r/LS3y-06yy <br /> TENANT MIL ADDRESS CITY ZIP PINDNE <br /> ATICNITECI OR DESIGNER WK ADDRESS CITY ZIP PHONE <br /> ODI Qlrh e l�4" 'lf "''re0 40 A)2-l71y <br /> GENERAL CONTRACTOR MAK ADDRESS CRY ZIP PHONE LICENSE <br /> [[[(]+]+]+ <br /> Trons�rC _1760) 24' �.fANNI(�lSGtr+�/) TUB» //DATA <br /> Rey MECHANICAL CONTRACTOR MAK ADDRESS CITY ZIP PHONE LICENSE <br /> joH <br /> a (n BOMBING CONTRACTOR NAK ADDRE65 CITY TIP PHONE LICENSE <br /> N L3 <br /> 'L <br /> CLASS OF WORK _ <br /> NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> O� 55yH <br /> CONTACT PERSO.AND PHONE N_O �Jp� A <br /> CONTRACT PRICE OF WORN �. QFC.Y�F4"1 lW 1,14 <br /> y �(U�u�YUAREF �INaVRLD <br /> pyp �'Jli its cF- ¢, 3s3 - s�� <br /> O Hd�y PROPOSED USE OF BUILDING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> H O �n P f G, �} C� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> 'n LEDAI DESCRIPTK]N OF PROPERTY JSNCNNN BELOW OR ATTACHFOIR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WIL' BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> H <br /> LOT BLOCK O y <br /> y y NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO DIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> W OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> Py PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> V1 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 PCW AND 298.200 WAC. <br /> y y SIGNATURE O CONTWTOR OR AUTHORIZED AGENT DATE <br /> PRafcr Annpess <br /> APPLICANTS CIN BUSINESS LICENSE NO AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) �I- A/C-AMNDLG UNITS-H.P. <br /> BATHTUB 0: - I FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORI (WASH BASIN) - UNIT HEATERS-B.T.U. M <br /> SHOWS P - CLOTHES DRYERS <br /> KITCHEN MNK 8 DISP /; ' VENTILATION FAN <br /> I DISHWASHER �'� - RANGE HOOD <br /> LAUNDRY TRAY _ f WATER HEATER <br /> CLOTHES WASHER - WOOD STOVE <br /> URINAL METAL FIREPLACE 6 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS X GAS PIPING ' <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE-BAR,ETC.) li/ll - - <br /> i <br /> I <br /> SLOB TOTAL f ; - SUB TOTAL 11 D' - <br /> �. PERMIT S PERMIT f <br /> TOTAL FEE $1 TOTALFEE $ v' = <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REARSETBACK SIDE SETBACK AN CNFCK NUMBER FEE RECEIPT ND <br /> do "40 <br /> USE ZONE LOT AREA VACANT TE FEES VALUATION FEE <br /> 07- BUILDING /U U (fU <br /> TYPE p S ALLOWABLE TYPE GI CONST ACIUAI OfLVAYt. "w im ACUI'm , <br /> PLUMBING 5, — <br /> IV <br /> SIZE OF SLOG TO OF STORIES BASEMENT MECHANICAL V ' — <br /> /1i77 t Sm3 , <br /> L-sF v <br /> OCCUK;YIOAD FIRE SPRNKLERS REOD HEIGHT LIMITTAATION ADDITIONAL PLAN CHECK i <br /> N A J �Q OTHER <br /> REASON FOR SPRNKLERS ' <br /> STATE BUILDING SURCHARGE i SU <br /> INTAKE BY PIANSAPPROYLOBY CITYOF EVERETPUBLICWORKS 'qp ) <br /> LOCAL SALES <br /> TAX CODE IS 3105 TOTAL Z i:� ; J <br />