Laserfiche WebLink
the Enrgmn <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />,% <br />APPLILATION FOR CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />Pvrngt <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICE N5f <br />AL-b�EST DEL/6coPM6AATT" TA,Ic (�_M� AS ABoL7F_, � r ElA�p�l/L�K MECHANICAL CONTRACTOR MAIL ADDRE99 CITY ZIP PHONE LICENSE• <br />X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ nEMOLITION n wnnnc.nvcrcola IMecv. fl e <br />-- <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONIY r <br />/ <br />CONTRACT PRICE OF WORK SlI <br />�Z <br />V / <br />CONTACT PERSON AND PHONE NO <br />EKE �C t7r MLrA� <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />I'auq <br />PROM OF BUILDING <br />-- <br />-- <br />1 HEREBY CERTIFY THAT I HAVE R :AD AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED V.'ITH <br />WHETHER SPECIFIED DOES NOT <br />PRESUME TO GIVE AUTHORIITY TO TTHEVVIIOLA E OR CAINCEL THEEFIMIT PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br />FORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAG <br />SIGNATTU RE OF CONTRACTOR OR AUTHORIZED AGE NT DATE <br />XALL- LOOF5T .D6lJ6LoPm0rJT Tr.lc- <br />LEGAL DE9CRIPIION RO IYISHOWNBELOWORAIT NFFUN COFE - <br />�.� '�`�A "•+«`rt <br />t ca A F ' 5 P �' `— D <br />/ / ('� <br />E <br />..w.... �Fy��,. yE�; - •- <br />PROJECT ADDRESS <br />/ <br />APPLIPFANTS CITY BUSINESS LICENSE NO ANO BUSW E59 NAME --rL— <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />A/C - A/HNDLG UNITS -H.P. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />'Z <br />WATER CLOSET (TOILET) <br />BATHTUB <br />FORCED AIR SYSTEMS - BT.LI. MEA <br />LAVATORY (WASH BASIN) <br />UNIT HEATER^, -BTU. M <br />SHOWER <br />_ <br />CLOTHES DRYERS <br />KITCHEN SINK DISP. <br />VENTILATION FAN <br />DISHWASHER <br />_ (�r <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE& CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />_ <br />BACKFLOWPREVENTERS <br />GASPIPING <br />ROOF DRAINS - RAINLEADERS <br />_ <br />EXHAUST FAN <br />SINK (SERVICE - BAR, ETC) <br />SUBTOTAL <br />& <br />SUBTOTAL & <br />PERMIT <br />$ <br />PERMIT E <br />TOTAL FEE <br />& <br />(. <br />_ <br />TOTAL FEE S <br />_ <br />FRONT SETBACK r <br />Lo <br />REARSETPACK <br />SIDE SETBACK <br />s' <br />PLAN CHECK NUKBER <br />Po .a s A� <br />FEES <br />FEE <br />VALUATION <br />RECEIPT NO <br />�I 838 <br />FEE <br />USE ZONE <br />(z—1 <br />TYPE OFCONST <br />ALLOWABLE/A TUAL <br />'14 <br />L07AREA <br />Z 3 70 <br />OCCUPANCY GROUP <br />.3 <br />Vy_lES �NTSITE n No <br />; <br />NO OF DWELLING UNITS <br />BUILDING <br />+b <br />_ <br />q73 <br />DU <br />PLUMBING <br />9RE OF flLGO <br />I%Z SF i <br />4% }y(M <br />NO OF 570RIES <br />BSA-1 <br />'.'Y <br />OCC LOAD <br />MECHANICAL <br />Q <br />OTHER CQMI <br />p/QI CIU <br />36L <br />/ <br />IIRE SPRINKLERS AEOUMED !I YES ri NO <br />-- <br />HEIGHT LIMITATION <br />STATE BUILDING SURCHARGE <br />APPL'C—Ai ION A G C BY PLANS APPR BY <br />9,p <br />N IVI <br />STATE ENERGY SURCHARGE <br />nr 1 <br />PUSLIC WORKS <br />TOTAL <br />Z <br />