Laserfiche WebLink
APPLICATIa_ FOR CONSTRUCT, JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />LHEATING SYSTEM: U GAS U ELECTRIC L I <br />BUILDING DEPARTMENT — <br />259-80 0 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNS MAIL ADDRESS CITY ZIP PHONE <br />^,�� -7�1 st SGErtt LYao3 :Z53-790 9 <br />{ TENANT I MAIL ADDRESS CITY ZIP PHONE <br />E AR.YAyy1DJ <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE F <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br />CUSS OF WORK <br />•rinx� oaonlo ncAAro ItION V WOODSTOVE/FRPL INSERT BUILDING RELOCAI ION <br />I.I IYCYY <br />__ <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK <br />-- <br />DESCRIBE WORK ANT) SOUARE FOOTAGE INVOLVED <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED USE OF BUILDING <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 />LEf.AI OE SCRIPTION OF PROPERTY ISiOWN RELOW OR ATTACH FOUR COPIES) <br />OF <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESI IME 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 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 WAG. <br />_ <br />91(4NAH nl F DAIL <br />PROJECT ADDRESS /Y <br />2 <br />fl 5iNf55 L2CNSL IN <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EOUIPMENT FEE <br />WATER CLOSET (TOILET) <br />_ <br />A/C—AMNDLG UNITS—H. P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.0 _M E.A. <br />UNIT HEATERS—B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />SHOWER <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />—i_ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />_ <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />T— <br />DRINKING FOUNTAIN <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 />SUBTOTAL $ <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />_ <br />— <br />TOTAL FEE $ <br />FOR OFFICE USE <br />ONE SETBACK <br />USE ZONE <br />ONLY: <br />REAR SETBACK--� <br />LOTAREA <br />SIDE SETBACK <br />VACANT SITE <br />PLAN CHECK NUMBER FEE <br />7 FEES VALUATION <br />RECEIPT N0 <br />FEE <br />_ <br />' <br />BUILDING <br />TYPE OF CONTS ALLOWABLE <br />IYP! DI LDNST ACTUAL <br />Ix:[uMxL. xa W MF, urns <br />cxav <br />PLUMBING <br />MECHANICAL <br />SIZE OF BLW <br />NO OF STONES <br />BASEMENT <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPHNKLERS REO'0 HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />