Laserfiche WebLink
APPLICATIkA FOR CONSTRUCR► .ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET R EVERETT, WA 98201 R 259-8810 <br />I DEMOLITION 1 I COMBINATION � I BUILDING Xi MECHANICAL PLUMBING i SIGN <br />ADDRESS <br />iS <br />VAII ADDRESS <br />Vh <br />TENAMNT�^ MAIL AODnrss f,ITY lIP rmw <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PNONF <br />GENERAL CONTRACTOR MAIL AD'InE55 CITY ZIP PHONE. STATE LICENSE R <br />MECHANICAL CONTRACTOR MAIL ADCRF.SS CITY ZIP PHONE STATF LICENSE R <br />S E 11 <br />rLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br />CONTRACT PRICE OF WOR <br />(-4� <br />HEATING SYSTEM: I GAS f 1 ELECTRIC I l <br />DESC IBE WORK AN <br />fLA-l--%�. <br />SO TARE FOOTAGE INVOLVED <br />CONTACT PFRSON AND PHONE NO <br />- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />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 />CONTR TORS LAW 18.27 CW AND 296.200 WAC, <br />X }a /� <br />PROeOSF.D USE OF BUILDING <br />LEGAL DESCRIPTION OF PnOPERTY (SHOVN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK — or <br />PARCEL TAXI D NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TFIEPHONE NUMBER- <br />SInNATUR DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />r— <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE. <br />_ <br />WATER CLOSET (TOILET) <br />' <br />A/C —A/HNDLG UNITS —H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WAST' BASIN) <br />I <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />' <br />KITCHEN SINK 6 DISP <br />i <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />' <br />VENTILATION FAN <br />; <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />~— <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />DACKFLOW PREVENTERS <br />i <br />GAS FIREPLACE <br />_ <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS RANGE <br />' <br />' <br />GAS PIPING <br />EXHAUSTFAN <br />I <br />I <br />I <br />' <br />' <br />1 <br />SUB TOTAL $ <br />SUB TOTAL S <br />PERMIT $ <br />I <br />PERMIT $ <br />_ <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />one nccLrc ncc nwl V. <br />FRONTSFIPACI <br />REAR SETBACK <br />SIDE SF TRACK <br />PI AN Cl Homan <br />SG FEES <br />FEF <br />RFCFIPT NO <br />USE ZONE <br />IGTAnFA VACANTSHF <br />VALUATION <br />FEE <br />BUILDING <br />�— <br />I1vrS 11 NO <br />HEIGHT LIMITATION <br />NO ar DWELLING SIN or BLOGITI <br />IINRS <br />rLUMemn <br />` <br />OCCUPANCY NO 01 STMES <br />GRWr <br />OCCUPANT LOAD BASEMENT <br />MECHANICAL <br />O� <br />I <br />IIYFS I NO <br />FIRE. ALARM PEO0 <br />RFASON <br />ADDITIONAL RAN CHECK <br />OT. P <br />FInF SPNINKIFR REO'D <br />REASON <br />DING SURCHARGE <br />MIRIN:WORKS <br />TYPE OF CONST <br />PI ANS ArrnovFn By <br />CITY OF EVERETT <br />LOCAL SALES <br />DATE <br />TAX CODE 15 3105 <br />TOTAL <br />