Laserfiche WebLink
aH <br />a H <br />axaxyC4 <br />YC n <br />O=0 <br />tH�1 <br />N H <br />H <br />z <br />0H <br />Hm8 <br />0. n <br />zH <br />z <br />HH <br />H <br />n L7 In <br />H CA <br />HOE4 <br />if <br />APPLICATIOA FOR CONSTRUCTIC,N PERMIT <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />I I I T I I <br />everett HEATING SYSTEM: JGAS OELECTRIC J <br />BUILDING DEPARTMENT <br />' 259.8810 <br />t DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY i yo <br />ZIP PHOHL _ <br />porn $ickj;; k 2-Wi-- TIP) 6Jf ?>LO- <br />TENANT MAIL ADDRESS CTIY 21P PHONE <br />ARCNITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />A <br />neunl ITTnM wnE.nsTnVFiFRPL INSERT BUILDING RELOCATION <br />- <br />- <br />CONTACTPERSONANDPHONENO <br />CONTRACT PRICE OF NVRK 2454 <br />DESCRIBE WORK AND 60uARE FOOTAGE INVOLVED 5PIIIti Au <br />PRorosEDusE euxDlNa 1 HEREBY CERT FY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LEGAL DISORIPPTION OF PROrERTY ISHOWNBELOWON A' 'A "FWR COPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK GF NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 PROPENTY 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 WAC. <br />SIGNA�T6CIlYI�C.TUU�RE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />APPLK,AN <br />urvrts;'— <br />----- -- - X Imo• <br />BUSWE IOENSENOANOBUSWESSNAME <br />PLUM ING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) _ A,G—AHNDLC UNITS—H.P. <br />BATHTUB FORCED AIR'..�STEMS—B.T.U. M E.A. . <br />LAVATORY (WASH BASIN) UNIT HEATERS—B.T.U. M i <br />SHOWER CLOTHES DRYERS ' <br />KITCHEN SINK A DISP VENTILATION FAN <br />DISHWASHER RANGE HOOD <br />LAUNDRY TRAY WATER HEATER <br />CLOTHES WASHER WOOD STOVE <br />_ URINAL METAL FIREPLACE d CHIMNEY ' <br />_ DRINKING FOUNTAIN 1 FIREPLACE INSERT <br />FLOOR DRAIN HEAT PUMP ' <br />BACKFLOW PREVENTERS GAS PIPING ' <br />ROOF DRAINS—RAINLEADERS 1 EXHAUST FAN ' <br />SINK (SERVICE —BAR. ETC.) <br />� 1 <br />1 <br />SUB TOTAL 6 i SUB TOTAL E <br />PERMIT $ PERMIT 6 r <br />TOTAL FEE E TOTAL FEE S ' <br />rwn wrvvuc <br />rwn wrvvuc <br />PLANCHECKNUMBEP <br />FIF <br />RECEIPT NO <br />FRONT SETBACK <br />REAR SETBACK <br />SIOE SETBACK <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE OI CONTS ALLOWART <br />TYPE OF CONST ACTuM <br />w wmtt AWrF <br />-- <br />Loa <br />PLUMBING <br />SIZE OF BLDG NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />i <br />�.CUPANCY LOAD FIRE SPRNKLERS REDD <br />HEIGHT LM17ATION <br />OTHER <br />i <br />I <br />.1 ASON FOR SPRINKLERS <br />1 <br />STATE BUILDING SURCHARGE <br />I <br />-' <br />CITY OF EVERETT <br />PUBLIC WORKS <br />--� <br />INTAKE By <br />PurES APPRGveo e1 <br />LOCALSALES <br />TAX CODE IS 3105 <br />TOTAL <br />m <br />