Laserfiche WebLink
■ <br />APPLICATIL A FOR CONSTRUCT .ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />❑ DEMOLITION ❑ COMBIIINATION F BUILDING , J ZMECHANICAL U PLUMBING ❑ SIGN <br />PROJECT ADDRESS: •�<cP Y \ c-U q'� <br />TENANT <br />MAIL ADDRESS <br />C.TY <br />711, <br />PIIONE <br />\AID lF <br />AnCHIT[CT On DESIGNER <br />MAIL ADDIS <br />City <br />p, <br />PHONE <br />GENEnAITCONTnACI <br />MAIL AODDESS <br />f.IIY <br />TIP <br />PHONE <br />STATE IICf NSE F <br />I�Lyt n,A CCYO <br />f <br />7 �+CO l�iC!,.�D�Ke <br />tF4 <br />L(`51�`t <br />Z.5 �IL.Iik <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />Cl TY <br />ZIP <br />PnO�r E <br />SIATF I ICENSE F <br />city ZIP - PHONE STATE LICENSE . <br />CONTRACT PRICE OF WORK 3 <br />L� <br />HEATING SYSTEM: 0�6AS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PFnSOU AN�D HON�E�Npe <br />—�J/Vl1 ocWn <br />n 1 <br />I HEREBY CERTIFY THAT 1 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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION 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 PR TY TO PERFORM THE WORK FOR WHICH <br />APPLICATION MA� COMPLY WITH THE STATE <br />CONTRACT LAW 1 WAN 296.200 WAC. <br />v <br />% <br />SIGNATUn DATE <br />PnoPOSED VSE OF PULL' 0 <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW ON ATTACNTVIOCOPIES) <br />LOT BLOCK or <br />PAncEL TAXI D. NUMBEA _ <br />/��1I 11r� c' <br />CONS ACTION LOAN TENDER ADOIE 5. TELEPIIONENUMPEn <br />CITY BUSINESS I WENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATEP. CLOSET (TOILET) <br />' <br />A/C—AlHNDLG UNITS <br />BATHTUB <br />; <br />FORCEDAIP SYSTEMS lLVIAL (,' <br />; <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />' <br />UNIT HEATERS <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />; <br />LAUNDRY TRAY <br />I WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BI IRN NG) _ <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />—T <br />SINK (SERVICE —BAR, ETC.) <br />rip <br />GAS PIPING S (% <br />_ <br />� <br />EXHAUSTFAN <br />,T <br />I <br />- <br />T <br />1 <br />SUB TOTAL <br />f <br />SUB TOTAL f <br />i i) <br />PERMIT <br />f <br />I <br />PERMIT f <br />/ I <br />TOTALFEE <br />f <br />TOTALFEE f <br />F[1R .7FFICF IISF ONLY. <br />FRONT SETBACK <br />NEAR SFIBACK <br />SIDE SFTPACK <br />PI AN CHECK NUMBfn <br />FFF <br />nFCFIPt NO <br />USE ZONE <br />101 AREA <br />VACANT SIIF <br />FEES <br />VALUATION <br />FEE <br />B'InING <br />OYES O W.) <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLOGnI <br />UNNS <br />PLUMBING <br />OCCUPANCY <br />NO OF SILKOES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />GAB, <br />�YFS ❑ NO <br />AD[NIIONAI Pi AN LI1(LK <br />FIRE SPRINKLER RED D <br />FIFASON <br />OTDEn <br />' <br />FIRE AIAPM AEG 0 <br />RFASOI <br />' <br />vME Bun DPn; Sun'I+naE <br />I <br />TYPE or coNst <br />PI ANS ArrnovF r, BY <br />CITY OF EVERETT <br />PGRnC. YmnKS <br />LOCAL SALES <br />--� <br />TAX CODE IS 3105 <br />TOTAL <br />RATE <br />3- <br />■ <br />