Laserfiche WebLink
APPLICATICA <br />FOR CONSTRUC'I_.)N <br />PERMIT everett <br />r <br />TO BE <br />COMPLETED IN INK —PLEASE PRINT <br />ensEF� <br />CITY OF <br />everett <br />I HEATING SYSTEM: ❑ GAS ❑ ELECTRIC -1 <br />71 <br />BUILDING DEPARTMENT <br />259.8810 <br />;.1 DEMOLITION <br />COMBINATION <br />BUILDING MECHANICAL <br />PLUMBING SIGN <br />r OYYNER <br />GytF B�.ui� <br />MAB ADDRESS <br />/�v Bcx�i <br />CITY ZIP I"•... <br />fur j�'aa3-,� <br />-4f9o?s <br />TENANT <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />ARCHITECT aI CES10NER <br />MAB ADDRESS <br />CITY 21P PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />LICENSE <br />MECHANICAL CONTRACTOR <br />MAR ADONESS <br />CITY ZIP PHONE <br />LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />LICENSE <br />r <br />C" <br />lwft� <br />CLASS OF WORK i-,.. nu.nl lrinM wnnnsrnVF/FRPLINSERT BUILDING RELOCATION <br />NEW 8uUl1IVrr nu cn...... K ..�. ..... __...__ <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK �P <br />SC*PNIE YANK ANp SGUAAEFOOTApE INV EO <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PRorosEo uses Ie <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 />LEGAL Oe SCRIPTION OF PROPERTY ISMOYM BELOW OR ATTACH IMP COPRSI <br />OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK <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 1 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 />PPOIEGI ADDRESS <br />I BUST L O � ESS NAME <br />PLUMBING <br />ECHANICAL <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. <br />TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) <br />A!C—AIHNOLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE 6 CHIMNEY <br />URINAL <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <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 />SUB TOTAL S <br />SUB TOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE $ <br />TOTALFEE f <br />run urrwc vac <br />vINT_Y. _ <br />PECEIPT NO <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />MANCHFCK NUMR <br />'1 1 •,I <br />IFf <br />VACANT SITE <br />(_ <br />USE ZONE <br />LOT AREA <br />FEES <br />VALUATION <br />FEE <br />I <br />BUILDING <br />.� <br />TYPE OF CONIS AILOWA9l( <br />TYPE DI CONST ACTU4 <br />I <br />PLUMBING <br />MECHANICAL <br />I <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />I <br />ADDITIONAL PLAN CHECK <br />OCCUPAYLOAD <br />NO <br />FIRE SPRINKLERS REDID <br />HEIGHT LIMITATION <br />I <br />OTHER <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY RANS APPROVED RY CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />1-49SZ <br />