Laserfiche WebLink
APPLICATION FOR CONSTRUCTION PERMIT <br />TO BE L.uMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS OSELECTRIC u <br />259-8810 <br />LI DEMOLITION Dk COMBINATION ❑ BUILDING I MECHANICAL I I PLUMBING 11 SIGN <br />bll. ur none <br />CITY ZIP PHONE <br />ARCH"ECT OR DESIGNER <br />MAIL ADDRESS <br />"W/� 2/,2 CITY ZIP <br />PHONE <br />CRAVE CIES/GA) <br />= 933 <br />&rNeu ur He .9OrAluz— <br />OENERALCONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE STATE LICENSE <br />ALYN Hordes <br />5Mlt hom <br />Pc. SE Eoe -;r 9aaoQ <br />937-997A ALYNHGcoeear <br />MECHANICAL CONTRACTOR <br />MAR ADDRESS <br />CITY ZIP <br />PHONE STATE LICENSE I <br />PLUM c�rrOR MAIL ADDRESS � �91 TY� ZIP PHONE STATE LICENSE F <br />V514TRACT PRI EOFW RK <br />DESCRIBE WORK AND SOUR TAGE INVOLVED <br />CONTACT PERSON A14D PHONE NO. <br />3 37— 9.1 •12- <br />10 LT D <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COP9ECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER 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 LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />W <br />AP IC TION IS MADE AND I COMPLY WITH THE STATE <br />CON CTORS LAW 1 7 RCW D 296200 WAC. <br />8 93 <br />PROCPOSED USE OF BUILDING <br />IJ �AXoL2 FAml L_Y QeS L DPJ]Tl AL <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />ri LOT BLOCK OF OeueaLYIPEA:F n'T'I: <br />SNORT PLAT RVLD" INfe 99 0 /001 ve <br />3URUey UOL. EFI L Pose, SAT ReNatol" 9309/0Soo / <br />RC(OIEO/RIG TO Pu4T tb O AGG <br />PARCELTAKID NUMBER V��LT-� <br />39�o-ago-o3�-osos charm_, <br />CONSTRUCTION LOAN LENDEfl. ACOflE S. TELEPHONE NUMBER 77S Jrfo <br />LYIU1JT�oon moare.�.f?�n�lat'°xGG�, <br />PROJECTADDRESS <br />D RIME' Ro- <br />SKIN CnL <br />CITYSe I CLNSE No <br />PLUMPING ,N7 <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />1 <br />ER CLOSET(TOILET) <br />I <br />A/C—AMNDLG UNITS—H.P. <br />HTUB <br />F <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />ATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />) <br />VENTILATION FAN <br />—. <br />DISHWASHER <br />' <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />_ <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />Zj <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />; <br />GCS <br />SUB TOTAL S <br />; <br />SUB TOTAL S <br />_ <br />PERMIT $ <br />I <br />PERMIT S <br />TOTALFEE $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK F <br />REAR SETBACK <br />SASETBA <br />PLAN CHECK NUMBER <br />FEE <br />RECEI NO <br />USE ZON <br />LOT AREA <br />VACANT SITE <br />ES n NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />// <br />I <br />TYPE OF CO Sf <br />NO. OF STORIE <br />Z <br />OttIIMICY <br />INO tlOMllWO Mari <br />SIZE OF BLCG <br />lamEl <br />411 SF GMACAE <br />FIRE SPRINKLERS REOTI <br />BASEMENT <br />YES Iw 0 <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />' <br />OCCUPANCY LOAD <br />A <br />FIRE ALARM REOD <br />HEIGHT LIM'TATION <br />l <br />OTHER <br />STATE BUILDING SURCHARGE <br />i <br />REASON <br />INTAKE BY <br />rl All S\I'Jtov(Dflv <br />JJ }{ <br />DAIL I 1.Z r_ y3 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />L i <br />TOTAL <br />iQ <br />