Laserfiche WebLink
APPLICATIOr' FOR CONSTRUCTI "N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT cr[kers <br />BUR DING DEPARTMENT HEATING SYSTEM: J GAS jjf_CTRIC U <br />?59-8810 <br />DEMOLITION COMBINATION I I BUILDING 11 MECHANICAL PLUMBING I I SIGN <br />O R MAIL ADDRESS CRV ZIP PHONE <br />5/li7� S1M t0r"ii 4.Rd 9pfl-0"5_a­- <br />gam// 4V2oy ass Yisy <br />TENANT <br />MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CRY ZIP PHONE <br />nisi _4 L:ivcs /9/S_ mAAsoAI Sf f!'txff,1 9Fzo3 3t3 <br />GENERALCONTRAC T ADDRESS CITY ZIP PHONE STATE LICENSE <br />�y 'MAIL <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE IT <br />PLUMBINO CONTRACTOR MAR ADDRESS CITY ZIP PHONE STATE LICENSER <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />dd Alm <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />S / ! <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�EGAL DESfl IPi ION OF PROPERTY (SHOWN BELOW OR AT UCH TWOCOPIESI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT•—� - BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />1�� ��S 1 <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />•J �iJ S •� t/ <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 <br />TO PERFORM THE WORK FOR WHICH <br />(FARCE ID MI]7 <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />/JX DO oo <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESS""' <br />S 2 •r� �y <br />S'GNM <br />,.K. <br />G <br />PATE <br />42M <br />CRY <br />—PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />O. TYPE OF EOUIPMENT FEE <br />WATER CLOSET?OILET) <br />T <br />A/C-A/HNDLG UNITS-H.P. <br />BATHTUB ' <br />FORCED AIR SYSTEMS-B.T.U. M E.A. I <br />LAVATORY (WASH BASIN) <br />( <br />UNIT HEATERS-B.T.U. M <br />' <br />III <br />SHOWER <br />CLOTHES DRYERS <br />, <br />KITCHEN SINK 8 DISP <br />' <br />VENTILATION FAN <br />I <br />DISHWASHER <br />1 <br />RANGE HOOD <br />LAUNDRY TRAY <br />I <br />WATER HEATERCLOTHES <br />WASHERT <br />WOOD STOVEURINAL <br />' <br />METAL FIREPLACE (WDRINKING <br />FOUNTAIN <br />MBURNING)."" <br />FIREPLACE INSERTFLOOR <br />DRAIN _ <br />' <br />HEAT PUMPBACKFLOW <br />PREVENTERS <br />; <br />GAS PIPINGROOF <br />DRAINS—RAINLEADERS <br />AUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />I <br />I <br />1 <br />i <br />I <br />I <br />I <br />'pp <br />SUB TOTAL $ <br />„1_ <br />_ <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />PERMIT S <br />1 <br />TOTAL FEE $ ' <br />TOTAL FEE $ I <br />FOR OFFICE USE ONLY: <br />�W, Lk <br />FRONT SETBACK BEAR 6ETBACK/ SIDE SE TRACK/ <br />o l%r <br />PLAN CHECK NUMBEq� FEE ./7 / RECEIPT NO. <br />�C <br />7 <br />USE YE LOT AREA VACANT SITE <br />//(J'! <br />FEES VALUATION FEE <br />X I -I YES D(-NO <br />iYM Df CONSi NO.OF STORIES ruuwxn no aownlixr. urns,i76 <br />BUILDING <br />_ _ __ ' o <br />7 <br />PLUMBING 0 <br />v 1 <br />aacc FIRE SPRINKLERS REGO � <br />L=f NiWAt f BASEMENT <br />MECHANICAL <br />.�Sz GAOAgE. O FI YES VNO <br />OCCUPANCY LOAD FIRE ALARM REOU HEIGHT77LPAI TION <br />/ <br />ADDITIONAL PLAN CHECK I <br />O G <br />REASON <br />OTHER — <br />5 <br />STATE BU LDING SURCHARGE <br />INT4<E BY IYANSAPPR�DBY CITY OF EVERETT <br />PUBLIC WORKS <br />14 LOCAL SALES <br />DATE G..7 3� �. TAX CODE IS 3105 <br />rIDTAL <br />J <br />