Laserfiche WebLink
1 <br />I <br />�I APPLICATIC-1 FOR CONSTRUCT"IN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: UGAS ELECTRIC U <br />259-8810 <br />[J DEMOLITION✓COMBINATION BUILDING I I MECHANICAL PIPLUMBING [7 SIGN <br />OVMER I�I AIMLADORESS CITY ZIP PHONE <br />�Tilyj brAM IAo Gla Gig �L sF Foe A 9W3 35.3 <br />TENANT MAILAODRESS CITY ZIP PHONE <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />GENERAL CONTIRACTOR MAIL ADDRESS CRY ZIP PHONE STATE LICE-NS-E8 <br />1 1.] I.OnSTY�yn H of It It 11 it / 7S 62gtK ,n L <br />MECHANICAL CONTRACTOR MAIL ADDRESS CRY ZIP PHONE STATE LICENSE II <br />TCT MA ADORE CRY 21P PHONE TAT(41C <br />L PLUMBING <br />luKIA J//PY A*69Ah w <br />CONTRACT PRICE OF ypR�A 44/z A� <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />i <br />ION Y' 1f071+'I <br />slivko' All <br />I 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 COMPLETED WITH A7HCTHER 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 I OCAL 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 />Q 7 <br />PROPOSED USE OF BUIt DING <br />LEGAL DESCRIPTION OF PROPER" (SHOWN BELOW ORII A*TLLITACJH TWO CQPIE ) <br />LOT BLOCK �— of NtiAA"�- ^S <br />�` j I pj�Dl'f <br />A 43 o s �q �Z <br />PARCEL TA%ID NUMBER <br />�/3 _ _ <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESS <br />sNNAront - BML <br />ulr nuswFss Hc[Nu np <br />PLUMBING <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 />I <br />A/C—A/HNDLG UNITS—H,P. <br />I <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEALERS—B.T,U. M <br />i <br />SHOWER <br />' <br />CLOTHES DRYERS <br />I <br />KITCHEN SINK & DISP <br />I <br />VENTILATION FAN <br />I <br />DISHWASHER <br />RANGE HOOD <br />I <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />I <br />URINA'_ <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />I <br />FLOOR DRAIN <br />HEAT PUMP <br />I <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />I <br />SINK (SERVICE —BAR, ETC.) <br />I <br />I <br />, <br />, <br />I <br />I <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />------------ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: S YVTOIC6 I)e:-,.e&To Ls IL6�(R' p AIZI o UGC, <br />FRONT SETBACK <br />REM SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />9 <br />FEE W <br />RECEIPT NO <br />U.,E ZONE <br />-,� <br />LOT AREA <br />ZA % <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />' <br />TYPE OT CONS( <br />, I <br />NO OF STORIES <br />OERAMKY <br />~ <br />NOMBMUMUNIIS <br />( <br />SI EQF BLOC <br />b Sf GYL fZ <br />FIRE SPRINKLERS MOD <br />o <br />MENi �� <br />❑ YES Y �N0 <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />, <br />'y <br />OCCUPANCY LOAD <br />FIRE ALAAm REOD <br />o <br />HEIGHT1yAI TI�M. <br />G <br />OTHER <br />T <br />S <br />REASON <br />STATE BUILD!NG SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />a <br />DATE c� LL q 3 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />