Laserfiche WebLink
APPLICATIvN FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET A EVERETT, WA 98201 E 259.8810 7T <br /> 1 1 DEMOLITION I I COMBINATION I BUILDING 11 MECHANICAL I I PLUMBING Fl SIGN <br /> PROJECT ADDRESS <br /> OWN R MAIL ADIIDLSS CITY ZIP PHONE <br /> MA++TfsoAl 1sy,,} �jjd"AU sE m,1� cv K 9r. I a - 514p <br /> TENANT MAIL ADDRESS CITY ZIP PUONE <br /> ARC107ECT OR DESIGNED MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAILADOPESS CITY ZIP PHONE STATE LICENSEE <br /> M141- -e50tJ C' Z)OSi, jIA MCL /ACZ 2A4IE4 9 <br /> MECHANICAL CONTRACTOR MAIL ADORESS CITY ZIP PHONE STATE LICENSE E <br /> PLUMBING CONTRACTOR MAIL ADORE SB CITY ZIP PHONE STALE LICENSEE <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM: 1,1 GAS I-1 ELECTRIC Fl <br /> DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED CONTACT PE HSON AND PHONE NO <br /> /O I HEREBY CERTIFY ?HAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY ISIroVrt/BELOW OR ATTACH WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> iWO COPIES) NOT. THE GRANTING OF A PERMIT DOES NOT, PRESUME TO GIVE <br /> LOT /,Z BLOCK _O=_ r�'� 1 ILA 4 P L-.S'I'N{Y•• 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 PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX 1 D.NUMBER CONTRACTOR AW 19.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENDER,ADMESS.TEIEPIIONE NUMBER q/ <br /> SIOf A I1RE DAT <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) I A/C—AMNDLG UNITS—H.P. I <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> 3 LAVATORY(WASH BASIN) I HEAT PUMP <br /> 1 <br /> SHOWER I UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK&DISP 1 CLOTHES DRYERS <br /> / DISHWASHER I VENTILATION FAN 1 <br /> LAUNDRY TRAY 1 RANGE HOOD ; <br /> / CLOTHES WASHER I / WATER HEATER 1 <br /> URINAL ' WOOD STOVE <br /> DRINKING FOUNTAIN I METAL FIREPLACE(WOOD BURNING) ' <br /> I <br /> FLOOR DRAIN I FIREPLACE INSERT(WOOD BURNING) I <br /> BACKFLOW PREVENTERS GAS FIREPLACE <br /> SINK(SERVICE—BAR, ETC) I GAS RANGE 1 <br /> ' OAS PIPING ' <br /> EXHAUST FAN T <br /> I I <br /> I I <br /> I 1 <br /> BUD TOTAL S ' SUB TOTAL $ ' <br /> _ PERMIT $ I PERMIT $ <br /> TOTAL FEE S V6 TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK DEAD SETBACK SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> `i <br /> USEZONE ,/)V/ tOTARA VACANT SITE FEES VALUATION FEE <br /> I)YES 11 f10 BUILDING <br /> IIEIGIU LIM�TI NO OF DWELLING BYIZOEI�BSOQ/TI <br /> �// UNITS f LLY"14 4 PLUMBING <br /> ALAF,6 <br /> OCCUPANCY NO Of BTINYES OCCUPANT)OAR BASEMENT MECHANICAL O <br /> 2 I 11YE5 <br /> rinE ALARM READ REASON ADDITIONAL PLAN CHECK <br /> OILER <br /> FIRE SPRINKLER REDD REASON <br /> STATE BUILDING SURCHARGE <br /> TYI �OF CONST PLANS APPROVE BY CITY OF EVERETT PUBLIC WORKS — <br /> LOCS <br /> DATE <br /> � 9G TAX CODEODEISIS 3105 TOTAL L <br />