Laserfiche WebLink
APPLICATIO FOR CONSTRUCTC'N <br />PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: S U ELECTRIC <br />❑ ______ <br />- 1 <br />BUILDING DEPARTMENT <br />259-8810 <br />� <br />� <br />r"FsLUMBING <br />DEMOLITION <br />CI COMBINATION BUILDING —MECHANICAL <br />SIGN <br />O R <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />tJ'7 �ec./✓; <br />/y10 73 47 5E EsV6ceZ1 <br />99r1os <br />3s3-xZ20 <br />TENANT <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />STATE LICENSE I <br />} CHANIOAI CONTR-'y�{��{iOH <br />MAIL A�D�ESSCITY ZIP <br />PHON <br />1'07 STATE LICENSE# <br />KeD r� /1�4P?/�G <br />t C mink /SdG 6 1✓e S: w%� yXoS1 <br />kyhWONc0'Xc4j. <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />STATE LICENSE <br />af7�7'Y16f <br />%Q'S i%%i1t~l� <br />00 <br />CONINACT PRICE VOnK / <br />DE,�S5j}''RIBS WORK AND SQUARE FOOTA INVOLVED <br />K2E7A''lVG i iN ! /N SiglG <br />.iXf <br />CONTACT PERSON AND PHONE NO O7S�` <br />7jb V I <br />wsmtC 64-, ii"/, Co ! SfR- <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 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 />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS AIN 18.17 RCW AND 296.200 WAC. <br />r _ <br />PROPOSEDUSE C�BNI <br />LEGAL DESCRIPTIONICIF PROPERTY (SHOWN BELOWOR ATTACH TWOCOPIES) <br />LOT BLOCK OF <br />PARCEL TAXI D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESS <br />c./ <br />s A"mE DMI <br />GIVRUS .fKfN51. <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 />A/C—AIHNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />_r <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />i <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />_ <br />LAUNDRY TRAY <br />i <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT 605 <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />I <br />r <br />r <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />Cno ^CCIl C "CC AABI V. <br />fRONTSETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPTNO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />-- <br />PLUMBING <br />I <br />❑ YES 17 NO <br />TYPE OF CONST <br />NO OF STORIES <br />O[CUNNR <br />°"01p <br />womumm.111 <br />SIZE OF BLDO <br />FIRE SPRINKLERS REOD <br />BASEMENT <br />MECHANICAL <br />' <br />❑ YES ❑ NO <br />ADDITIONAL PUN CHECK <br />I <br />OCCUPANCY LOAD <br />FIRE ALARM RED D <br />HEIGHT LIMITATION <br />I <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />� <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />PUBLICWORKS <br />i <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />