Laserfiche WebLink
APPLICATh—,dN FOR CONSTRUC . ION PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ADDRESS: Z�q 6"91- 'SI m <br /> O a E55 CITY tlr rNONE <br /> TENANT MAIL ADDRESS CITY ZIP 1`IIGNE <br /> AFILIIOCLTMDESIGNEB MAIL ADDRESS CITU llr PHONE <br /> GENERAL CONTPACTOR MAIL AD01155 MY -- ZIP PRONE STATE LICENSE• -- <br /> MECHANICAL CONTRACTOR AML ADORE SS CTEV 71P PRONE STATE LICENSER <br /> PLUMBING CONTRACTOR MAIL ADORE SS CITY ZIP PRONE STATE LICENSE• <br /> CONTRACT PRICE or WO IK HEATING SYSTEM- ❑GAS ❑ ELECTRIC ❑ <br /> DESCRIBE WOIOI AND SOUA IE FOOTAGE INVOLVED CONIACT PERSON AND PITO` NO <br /> / it - <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PEA"SEDUSE OF BUILONO PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRIPTION Or PROPERTY ISIIOWN BELOW CA ATTACH TWOCOPIESI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> Loi BLOCK Gr AUTHORITY TO VIOLATE OR CANCEL THE PROVISION 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 COMPIY WITH THE STATE <br /> PARCEL TAX I D.NUMBER CONTRA ORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENOFR,ADDRESS.TI LFERCINE.NUMBER <br /> SIGNATURE DA E <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A7C—MiNDLG UNITS <br /> BATHTUD FORCED AIR SYSTEMS i <br /> LAVATORY(WASH BASIN) HEAT PUMP ' <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISP CLOTHES DRYERS <br /> DISHWASHER ' RANGE HOOD <br /> LAUNDRY TRAY ) WATER HEATER <br /> CLOTHES WASHER WOOD STOVE _ <br /> URINAL METAL FIREPLACE(WOOD BURNING) I <br /> INKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) <br /> DR <br /> FLOOR DRAIN GAS FIREPLACE <br /> DACKFLOW PREVENTERS GAS RANGE <br /> SINK(SERVICE—BAR. ETC.) GAS PIPING — <br /> EXHAUST FANSUB .— <br /> SUBPERTOTAL IT s PERMOTAL IT = <br /> TOTALFEE f ' TOTAL FEE f <br /> FOR OFFICE USE ONLY: <br /> PIAN CIICCK NUMn fIF RECEIPT NO <br /> FD)NT SETBACK RE AR SETBACK iPACK SID SETBACK �� )�� <br /> FEES VALUATION FEE <br /> USE ZONE LOT AREA VACANT SITE T <br /> ❑YES ❑NG <br /> BUILDING <br /> HEIGRT LIMITATION NO Or(MELLING SIZE Or BLDGZTI I <br /> UMIS PIOMnIN G <br /> OCCUPANCY 110 M SUXBEs OCCUPANT LOAD BASEMENT MFCRANICAI <br /> Gnpm — <br /> DYES ❑NO <br /> ADDTIONAI PI AN CRIT CK <br /> FIRE SPRINKLER REOD RF ASOW -----� <br /> nlllE R _ <br /> FIRE ALARM REG'D FIT AEON <br /> SLATE nun DING SHnCIIAnDE <br /> R FE Or LLRSr moils Anrnovrn nr CITY OF EVEREST runnP. RFKS _ <br /> LOCAL SALES _-- 1 <br /> DAn TAX CODE IS 3105 TOTAL __ <br />