Laserfiche WebLink
F <br />cz <br />APPLICATit,.N FOR CONSTRUCT oON PERMIT <br />CITY OF <br />everett <br />BUILDING DEPART MENT <br />• 259-8810 TO BE COMPLETED IN INK —PLEASE PRINT <br />DEMOLITION COMBINATION ` BUILDING MECHANICAL <br />OWNER MAR ADDRE" _ - CITY ZIP <br />'. _.----PI <br />PLUMBING SIGN <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />:In <br />PHONE <br />OENERAL CONTMCTOR <br />MAIL ADDRESS <br />CITY <br />zip <br />PHONE <br />LICENSEE <br />air/ EJc,Z <br />MECHANICALCONTRACTOR <br />MAR ADDRESS <br />CITY <br />ZIP <br />nHONE <br />LICENSEE <br />PLUAIBBIG CONTRACTOR <br />MAIL AUDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />•ce AYInAI MCDA10 nFMnL ITION WOODSTOVE,FRPL INSERT BUILDING RELOCATION <br />Tnw•..•. ..�. _......_.. <br />__ <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTACT PERSON AND PHONE TIC <br />CONTRACT PRICE OF MORN: <br />DESCRIBE WDRK AND SQUARE FOOTAGE INVOLVED <br />PROPOSED USE OF BUILDING <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�- <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />IEdLL OESCRIPTIGN OF PROPERTY ISNGYIII BEIOW OR ATTACH FOUR COPIESI <br />,' <br />LOT BLOCK' L'/%F 4d! <br />U/✓ Z <br />4 n y <br />-�-/ Cs U'% Ifa <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />—�— <br />P /d ✓Y2 D v7 ?,,k <br />HL w <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REUULATING 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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />S^ D0 <br />I llohCT ADDRESS <br />4 <br />APPLICANTS CRY BUSIHESBINTENSE NO AND BUSINESS NAME — <br />PLUMBING <br />MECHANICAL _ <br />NO. TYPE OF FIXTURE OR IT 1M <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A'C-AHNDLG UNITS-H.P <br />BATHTUB <br />_ <br />_ <br />FORCED AIR SYSTEMS-B T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />�— <br />UNIT HEATERS-B.TU, M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINKS DISP <br />_ <br />_ <br />VENTILATION FAN <br />RANGE HOOD <br />DISHWASHER• <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />--r <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />_ <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ _ <br />gOOF DRAINS-RAINLEADERS <br />--T— <br />EXHAUST FAN <br />_ <br />SINK (SERVICE -BAR, ETC.) <br />_ <br />SUBTOTAL <br />6 <br />SUBTOTAL $ <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE $ <br />11W SETBACK <br />BEARSEIBAC <br />SIDE SEIB)CK A <br />PIAN CIIECK NUMBER / FEE p _ <br />v r S8' s 0 <br />RECEIPTNO <br />S .3 <br />��� <br />e i D <br />USE ZONE }'] <br />101 AREA <br />vACANT slrE <br />FEE9 VALUATION <br />FEE <br />YES 00- NO <br />BUILDING <br />TYPE OF CONSI AI LOWABIE <br />TYPE DI CORSI MTIIAI <br />nLlwxr <br />nAuu <br />n a IM11IiA4NVT5 <br />— <br />I <br />I <br />PLUMBING <br />SIZE OF SLOG <br />I10. OF STORIES <br />BASEMENT <br />MECHANICAL <br />Z S•F. <br />1 <br />YES k NO <br />OTHER <br />OCCUPANCY LOAD FIRE SPRNKLERS REOD <br />HEIGHT LIMli <br />STATE BUILDING SURCHARGE <br />' <br />YES 1< NO I S <br />REASd/ FOR SPRINKLERS <br />_ <br />STATE ENERGY SURCHARGE <br />r <br />APPLCATIONACC BY <br />PLANSAPPROVEDBY <br />CITY OF EVERETT <br />PURLIC WORKS <br />LOCAL SALES <br />7 <br />TAX CODE IS 3105 <br />i TOTAL <br />S <br />