Laserfiche WebLink
APPLICATIO FOR CONSTRUCTS ')N PERMIT <br />CITY OF EVERETT R BUILDING DIVISION <br />3200 CEDAR STREET R EVERETT, VI 98201 •259.8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING JAMECHANICAL 'P4LUMBING ❑ SIGN <br />PROJECTADDRESS:_.A(A — (Da- <br />Comm MAT ADDIIESS CITY lip - PHONE <br />ARCHITECT ON DESIGNER MAIL ADDRESS <br />--;Iv - <br />P110NF <br />GENERAL CONTRACTOR MAIL ADDRE SS CITY AE PI IONS STATE LICENSE• <br />MECNANICALL C�°�+1➢ACI MAIL ADDRESS CITY lip PHONE STATE LICENSER <br />iL <br />WA icy KsaEiiL� 7�i_LXl-7i{���--`� <br />PIU BMCOWRACTOR MAILADDRESS CIIY IP PIIONE STATE LICENSER <br />n1AaTHIAi 1-11A3 t—�' 7. <br />CONTRACT PRICE OF wogs 21GI5 <br />HEATING SYSTEM: P16AS ❑ ELECTRIC ❑ <br />DESM NORM AND SQUARE FOOTAGE I VOIVED <br />'jjZji cEfiLL <br />CONTACT PERSON AND PHONE NO <br />M T �I S <br />75.7- 40rl <br />_PV <br />III <br />AminoI <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE C:'APLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUC AT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROP TO P RM T WORK FOR WHICH <br />APPLICATION IS E CO WITH THE STATE <br />CONTRACTORS TB. .2 AC. <br />` ( <br />X <br />PROPOSED USE OF B& <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELI OR ATTACK TWOCONES) <br />LOT BLOCK OF <br />PARCEL TAKID.NIDABER <br />C� O <br />NUMBER CONSTR <br />IICIK}I LOAN I ENOF.R. AGglEss. fELEMDINE <br />SIGNATURE DATE <br />CITY BUSINESS SC POO <br />PLUMMNG <br />MECHANICAL _ <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE _ <br />WATER CLOSET (TOILET) <br />AIC — AlHNDLG UNITS <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />T <br />_ <br />SHOWER <br />' <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />) <br />CLOTHES DRYERS <br />DISHWASHER <br />I <br />RANGE HOOD <br />T <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />�— <br />URINAL <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />i <br />�— <br />FLOOR DRAIN <br />' <br />GAS FIREPLACE <br />BACKFLOW ^REVENTERS <br />; <br />GAS RANGE_ <br />; <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS PIPING <br />_ <br />EXHAUST FAN <br />i <br />I <br />I <br />) <br />SUB TOTAL S <br />SUB TOTAL S <br />J i <br />PERMIT $1 <br />PERMIT f <br />_ <br />TOTAL FEE S I <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SE TRACK <br />SIDE SETBACK <br />PI AN CIICf.K MIAa11R <br />ffi <br />Rf CFIPF NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />nTKI DINR <br />I <br />DYES ❑ NG <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF 11II <br />------ — <br />UNIiS <br />Pu11AaPlG <br />I <br />OCCUPANCY <br />NO LIP 11001111 <br />OCCUPANT LOAD <br />BASE 4EN1 <br />MTC HANKAL <br />GROUP <br />I <br />AUDIIIONAI PIANCIIICK <br />i <br />FIRE SPRINKLER REO'D <br />RFASON — <br />mHiR <br />FIRE ALARM RED <br />PEASON <br />I- <br />S1ATf 11111LDIRR SI PICIIATRF <br />i <br />1 _ <br />TYPE LD C,ONST <br />TIT AI APPROVE D BY <br />CITY OF EVERETT <br />real Ir, woI1KA <br />-- "'— <br />LOCAL SALES <br />-- -- <br />---- <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />e <br />