Laserfiche WebLink
e/ <br />ym, <br />4111111111, <br />ul <br />APPLICATIO..+ FOR CORNSTRUCT6jN PERMIT n <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />ply <br />CITY OF <br />eve rett HEATING SYSTEM: AS O ELECTR C <br />BUILDING DEPARTMENT <br />269.8810 <br />DEMOLITION COMBINATION BUILDING ECHANICAL PLUMBING <br />OWNER � MAIL ADDRESS CITY ZIP PHONE <br />ram, J1J.1 Ih,iAlnbflF iilr 7�Si s� . 4-l1tJV s7i- <br />SIP <br />ARCHITECTORDESIGNER MAIL ADDRESS CITY ZIP PHONE <br />PLUMBBIGCONTRACTOR MAILADURESS CITY ZIP PHONE LICENSE <br />�, <br />CLASS OF WORN nu .COAIG TT9MFI1 ITInN WOOOSTOVE/FRFL INSERT L. BUILDINGRELOCATION <br />(JV <br />CONTACT PERSON AND PHONE NO. <br />r-4 <br />GONTMG7 PRICE OE WORK <br />DESCRIBE WORK AND SCKIFOOTAGE INVOLVED <br />APOP <br />PROMISED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />5 <br />APPLICATIrN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIOI IS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI. BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIESI <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />��,�T,••�� <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 LAW 18.27 RCW AND 296 200 WAC. /� ��_ <br />OR AUTHORIZE AO NT DATE <br />SIGNATURE OF CONTRACTOR <br />` <br />X <br />2e:51e <br />_ <br />4 <br />h <br />PROJECTADDRESS <br />/_ l!r <br />�Loa <br />APPLICANT CITY BUS SS LICENSE NO AND BUSNESS NAME <br />PLUMBING I <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPEOFEOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE & CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />EAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />' <br />I <br />' <br />I <br />SUB TOTAL E <br />' <br />SUB TOTAL <br />PERMIT E <br />' <br />_ PERMIT E <br />TOTALFEE E <br />' <br />TOTALFEE E <br />?o : <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />III <br />RECEIPT NO <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHUCK <br />TYPEDFCGNISAL:ONABIE <br />TYPE OF CONST ACTUAL <br />FOUL <br />An dvNn'Iwrdeo <br />SIZE OF BLDG <br />NOOFSTORIES <br />BASEMEN <br />O <br />OCCPANCY LOAD <br />U <br />FIRE SPRNKLERS REM HEIGHT LIMITATION <br />OTHER <br />I <br />REASON FOH SPRINII'. RS <br />STATE BUILDING SURCHARGE <br />1 <br />WAKE BY PUNS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />; <br />TOTAL <br />p 1 O0 <br />