Laserfiche WebLink
I <br />APPLICATI" FOR CONSTRUCT -IN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT OfW77 <br />BUILDING DEPARTMENT I HEATING SYSTEM: U GAS U ELECTRIC J _ <br />259-8810 -- <br />I_I DEMOLITION I COMBINATION 9 BUILDING I I MECHANICAL i I PLUMBING 11 SIGN <br />DWIIER MAIL ADDRESS CITY ZIP PHONE <br />Fagerholm 10220 N. E. Points Dr. Kirkland, MA 98033 (206) 889-0606 <br />TENAN! MAIL ADDRESS CITY ZIP PHONE <br />C. Llovd Johnson Co Inc 8031 H t <br />+_ amp on Blvd Norfolk Va 23505 (8041 423 2832 Ext 400 <br />Am,'ItUlA ULSIGNER <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />— <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR <br />MALL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />STATE LICENSE+ <br />COWRACTOII MAIL ADDRESS <br />ZIP PHONE STATE LICENSE I <br />CONTRACT PRICE OF WORK <br />— <br />$30,000.00 <br />DESCRIBE RIBE K AND _pallit sto!FOOTAO INVOLVED <br />Install Dallet storage racking per _ <br />COATACI'PERSONANDPHONE 290 /T7_5/27/93 <br />James G. Carnfort% <br />Attached drawing <br />�f - fto" <br />_ <br />m-PowpLl r y� <br />— <br />Jf0d -Ye? 9/ya <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED usE of BUILDING <br />Marehoust <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 DESCRIPTION O=PROPERTY SHOWN BELOWOR ATTACH iWO COPiE51 <br />LOT—___ BLCAK —_— OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTI-IER 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 />PARL:E.TAKI.D.NUMBER <br />CONTRACTORS LAW <br />///1!l78.27 RCW AND 296.200 WAC. <br />CONBTRUJTKXI LOAN LENDER, ADDRRRR=SS TELEPHONE NUMBER�� <br />i ,5"-�D-93 <br />PROJECT ADDRESS — — "— <br />S ,AIM[ / OAIE <br />J� (� <br />1420 80th St. Suite Everett, WA 98203 <br />_F. <br />PLUMBING <br />CITI PIAM SS l �IJN5IN0 <br />_ _ <br />NO. TYPE Or iix TUI . FF. E OR ITEM <br />MECHANICAL <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />--�-... <br />_ WATER CLOSET (TOIL E1) l I <br />A/C—ARHNDLG UNITS—H.P. <br />FORE_LC AIR SYSTEMS—B.T.U. M E.A. <br />UNIT He ATERS—B.T.U. M <br />CLOTHES DRYERS <br />—~— <br />BATHTUB <br />—_� <br />LAVATORY (WASH BASIN) <br />, <br />; <br />SHOWtR <br />' <br />KITCHEN SINK 8 DISP <br />I ' <br />VENTILATION FAN <br />I <br />DISHWASFE 9_ <br />I <br />RANGE HOOD <br />, <br />LAUNDRI TFAI' <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />, <br />WOOD STOVE <br />; <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />, <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />I <br />— <br />ROOF DRAINS—RAIN_EADERS <br />EXHAUST FAN <br />— <br />SINK (SERVICE —BAR. ETC <br />- <br />i <br />� <br />I <br />l <br />I <br />I <br />SUB TOTAL $ <br />; <br />SUBTOTAL $ <br />' <br />PERM T $ <br />, <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTALFEE $ <br />! <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHE NUMBER <br />FEE /jO <br />RECEJET <br />o(', <br />(n/ <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />' <br />tYPEorcoNsr. <br />G <br />No ofsroRlEs <br />ocanAKcr <br />GAauA <br />KPaartullown <br />PLUMBING <br />i <br />�— <br />6UE OF BLD3 <br />IRE SERINKLERH REO'D <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />—_ <br />OCCUPANCY EGAD <br />FIRE M'COD <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />t <br />DATE C �3 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />