Laserfiche WebLink
APPLICATICK I FOR CONSTRUCT" <br />IN <br />PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRIM! <br />HEATING SYSTEM: J GAS J ELECTRIC <br />J <br />BUILDING DEPARTMENT <br />259.8810 <br />L 1 DEMOLITION <br />i 1 COMBINATION BUILDING i ;MECHANICAL <br />PLUMBING i SIGN <br />OWNER T <br />MAIL ADDRESS CITY ZIP <br />PHUNF <br />TENANT <br />MAII ADDRESS CITY ZIP <br />PHONE <br />— <br />// <br />��oY g, <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY Zlp <br />PHONE <br />GENERAL CONTRACTOR <br />� I�n ��r <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />STATE LICENSE F <br />MECHANAAL CONTRACTOR <br />MAILADDRESS CITY ZIP <br />PHONE <br />STATE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />STATE LICENSE <br />CONT CT PRIf.E OF WORK <br />A` <br />DESCRI E RK AND SOU REF AGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND F IAMINED 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 '.'HE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH $HE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />F <br />SWiNruRL / rF <br />PROPOSEDLISE BUILDING <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIESI <br />LOT BLOCK OF <br />PARCEL <br />II}} I D NUMBER <br />C UCTION LOAN L�ER. ADDRESS. TELEPHONE NUMds, <br />PROJECT ADDRESS <br />cvv nvsmissuq aHo <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—AHNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY "WASH BASIN) <br />. <br />UNIT HEATERS—B.T.U. M <br />; <br />SHOWER <br />' <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />' <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />. <br />FIREPLACE INSERT <br />—1— <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />—T <br />SUB TOTAL $ <br />; <br />SUB TOTAL S <br />PERMIT $ <br />PERMIT $ <br />_ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: FJ q;wfdy <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHE KNUMB[ H <br />rEF <br />RECEIPI NO <br />�3 to 07 <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />%. YES ❑ NO <br />BUR.DMG <br />TYPE ac6NSt <br />NO OF STORICs <br />occuw.n <br />AoaovnL.AIe M,In <br />--- <br />cAax <br />PLUMBING <br />SIZE OFBLDO <br />FIRE SPRINKLERS REO'D <br />BASEMENT <br />MECHANICAL <br />�— <br />. <br />EJ YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM REGD <br />HEIGHT LIMITATKW <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />i <br />INTAKE BV <br />PLANS APPROVED RV <br />CITY OF EVERETT <br />PUE1901rORKS <br />LOCAL SALES <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />