Laserfiche WebLink
APPLICATIG J FOR CONSTFIUCT_ JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM rlk4AQ <br />BUILDING DEPARTMENT 64ELECTRIC O_ <br />259-8810 <br />DEMOLITION <br />COMBINA(ION <br />V61LDING MECHANICAL <br />SIGN <br />O ER ` <br />or-� <br />l •, G,p <br />MAIL ADDRESS <br />�„�_ 21z <br />CITY ZIP <br />S+s>` aitrrF KAA'i <br />_PLUMBING <br />PHONE <br />-gr0-7Z <br />W7 9>1r67 <br />TENANT <br />MAT ILADDRESS <br />CITY ZIP <br />PHONE <br />— <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY Zip <br />PHONE <br />' <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY, ZIP <br />PHONE <br />STATE LICENSE I <br />.At <br />M CHANICAL CONTRACTOR <br />S &k <br />MAIL ADDRESS <br />C17Y ZIP <br />PHONE <br />STATE LICENSE IF <br />., , <br />X3 sue, _ <br />neyi PPS <br />>F-i:- ras d A <br />PLUMBMO CONTRTOP , T <br />MAIL ACORESS <br />fory ZIP <br />PHONE <br />STATE LICENSE) <br />ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVPIFEAPI IMSFPT PI nI FlIM!] DCI MATVYKI <br />,�{{ <br />CONTRACT PRK LOF WORK TJ <br />CDN A'I PERSON'AN 1D:• NO. t� p y <br />(ACT �,/� yS/� ♦ �(A / <br />DESCRIBE WORK AND FOOT El VOLV D <br />` �p <br />TROPES DOSE t OF BUILDINGSOUARE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN:D 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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESI )ME 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 />A� <br />LEGAL DESCRIPTIONOF PROPERTY ISHOWN BELOW OR ATTACH FOOT COPIES) <br />LOT 2 BLOCK of S� �n=�/ I <br />n -- <br />PROIEC T ADDRESS l <br />/- <br />3a 3Y S� <br />- <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR .TEM <br />FEE <br />NO. <br />TYPE OF EQUIPME147 <br />FEE <br />2- <br />WATER CLOSET (TOILET) _ <br />BATHTUB _ <br />LAVATORY (WASH BASIN) _ <br />SHOWER <br />KITCHEN SINK A DISP _ <br />DISHWASHER <br />Q I - <br />AIC-MHNDLG UNITS-H.P. <br />, <br />- '- <br />( <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />% <br />UNIT HEATERS-B.T.U. M <br />_ <br />; <br />-'- <br />CLOTHES DRYERS <br />T- <br />;- <br />VENTILATION FAN <br />' <br />_ <br />•' I- <br />RANGE HOOD <br />WATER HEATER <br />LAUNDRY TRAY <br />_ <br />CLOTHES WASHER <br />I - <br />' <br />_ , <br />' <br />; <br />WOOD STOVE <br />; <br />_ <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />I <br />DRINKING FOUNTAIN <br />-- <br />FIREPLACE INSERT <br />_ <br />I ' <br />FLOOR DRAIN _ <br />BACKFLOW PREVENTERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR. ETC.) <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />rfA <br />I <br />' <br />I <br />, <br />I <br />I <br />— ' <br />' <br />SUB TOTAL $ <br />•s ; - <br />SUB TOTAL $ <br />' -- <br />__ PERMIT $ <br />PERMIT $ <br />I <br />TOTAL FEE $1 <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: Ila-c t is� y/.5 <br />FRONTSE7BACN <br />�' <br />REAR SETUACI) <br />05 <br />SIDE SETBACK <br />PLAN CHECK NUMBS <br />- c,L�j� <br />FEE <br />'1:5o <br />RECEIPT NO <br />&;;l S-/ <br />USEZONE <br />LOT AREA <br />OS <br />VACANTSITE <br />If'S <br />FEES <br />VALUATION <br />BUILDING <br />C <br />f-FEE <br />s'� <br />TYPE OF CENTS ALLOKAZLE TYK M CONST. ACTUAL <br />SIT <br />S� 91.1 i t NO OF STORIES <br />OCCUPANCOAD FIRE SPRINKLERS NEED <br />YES <br />REASON FdR SPRINKLERS <br />BASEMENT <br />PLUMBING <br />MECHANICAL <br />, <br />y <br />i <br />ADDITIONAL PLAN CHECK <br />HEIGHT LIMITATION <br />Z <br />Z8 <br />SPRINKLER <br />i <br />STATE BUILDING SURCHARGE <br />----j---- <br />y Q <br />INTAKE BY PLANS APPROVED BY CITY OF EVERETT <br />`J H LOCAL SALES <br />CODE IS 3105 <br />PUBLIC WORKS <br />De <br />TOTAL <br />7 Ipo <br />1 <br />