Laserfiche WebLink
APPLICATICA FOR CONSTRUC7 .4)N PERIMIT <br /> �* <br /> CITY OF EEET s E •BUILDING <br /> WA DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 •259.8810 <br /> F' DEMOLITION COMBINATION BUILDING El MECHANICAL I PLUMBING I SIGN <br /> PROJECT ADDRSS " ,T <br /> ER MAIL App11E55 /� CIT/y� ''`/ TIP PHONE <br /> L�I.I. Air �/� 111LKTTi11(p1.)n C`JF'! 7� <br /> TENANT MAILADLRESS CITY ZIP PHONE <br /> A IITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> 1 P c ,l �;,nl<s 1915 MAL Lc /0 ,E kierr4 fi)Q 99eio sS3 - n53 <br /> nENERALCONrMCTOn MAIL ADDRESS CITY ZIP PHONE $ATE LICENSE• RC O•/ <br /> 1L \ 1,CC DAIAI� (,Ic_1 ;a�) Q0O4__�(Y &tt0rhL. ,k l+e,J�H qk?-�s (2cy 7I�/��/ �,�'- 'V <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE. STATE LICENSE I <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM' GAS FI ELECTRIC Fl- <br /> CONTACT <br /> DESCRIBE WOR ANDSWARE FOOiAOE INVOLVED PERSON AND PHONE NO <br /> f <br /> EL /e. <br /> I HEREBY CERTIFY THAT 1 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 /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESC TION OF PR)PE• YISRI{NN BELOW OR ATTACH TWE „GPI NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT= BLOCK of — 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 I'3 10IMSER C�I�•TRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> t RA 71ON LO L c AD BELE n IIIIIAy <br /> CONSTRUCPO/nNT LOAN:Elf..:fl,ADDRESS.TELEPHONE fNM'IER <br /> \11�Q _ s IAC_ Ri SA)o{\ SIG E \ DATE <br /> �� 0E -14 SsS rl Y BUSIN-SS UCLNSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> L- WATER CLOSET(TOILET) �— A/C—A_MNDLG UNITS--H.P. T— <br /> 'L BATHTUB ( ,�,c FORCED AIR SYSTEMS—P.T.U. ?A E.A. <br /> JL <br /> LAVATORY(WASH BASIN) _ I HEAT PUMP__ —i— <br /> SHOWER UNIT HEATERS--B.T.U. M <br /> KITCHEN SINK 6 DISP _ ; CLOTHES DRYERS <br /> DISHWASHER _ I VENTILATION SAN <br /> LAUNDRY TRAY RANGE HOOD ; <br /> _ CLOTHES WASHER --_� WATER HEATER I_ <br /> URINAI ' WOOD STOVE ' <br /> DRINKII:G FOUNTAIN METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN _ i_ FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS _ GAS FIREPLACE <br /> SINK(SERVICE—BAR, ETC.) I GAS RANGE —�—_ <br /> ' O GAS PIPING ' <br /> EXHAUSTFAN I <br /> I , <br /> K SUB TCTAL E SUB TOTAL $ ' <br /> PERMII S I _ PERMIT $ 1 <br /> _ TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK PFAR SE70ACK SIDE SEIB PLAN CHECK UMOfR fCF RECEIPT NO <br /> usEzoN¢m —� LOTAREA 3/Q VACANT SITE FEES VALUATION FEE <br /> FIYFS fl NO BUILDING b 5 <br /> HEIGHT LIMITATION f NO Q<OWELLING 517E Of BLDGR <br /> 8 UNITS AAi33 JF 41v,,✓Cm 4- PLUMBING <br /> 3 <br /> OCCUPAN �sAoAr.E <br /> CY NO Of STORIES OCCUPANT LOAD BASEMENT <br /> — <br /> OR Ur MECHANICALp <br /> 3 1/ I /L/ A LYES W<O <br /> FIRF ALARM REO'0 REASON ADDITIONAL PLAN CHECK <br /> OTHER /O <br /> FIRE SPRINKIFR RED REASON <br /> STATE BUILDING SURCHARGE <br /> TYPE OF CO ST rLANSA�T� <br /> DRY CITY OF EVERETT PUBLIC WORKN eo <br /> LOCAL SALESZQ 2150/,/ DATE 3 ' TAX CODE IS 3105 TOTAL <br />