Laserfiche WebLink
APPLICATIC J FOR CONSTRUCT _ JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: U GAS LECTRIC U J <br />BUILDING DEPARTMENT <br />259-8810 <br />_0_EMOLITION COMBINATION <br />OWNER MAIL ADDRESS <br />TENA MAIL ADUREDS <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />GENERAL C6NI FACTOR- MAIL ADDRESS <br />MECHANICAL COI I -RAC Y jR <br />�w i -Ae" <br />PLUMBING i. RACTUR <br />BUILDING MECHANICAL. PLUMBING SIGN <br />CITY lip PHONE <br />�e 3E. iSo1-t%(3I1114 <br />CITY ZIP PHONE <br />CITY ZIP <br />a -lq Ayt SF dii EuMeiF 1y40% j4S` I#SjLeea.j 1�'lA4g <br />CITY ZIP PHONE STATE LICENSE . <br />ImAY( ll T2r6N- T4s-tall _oAxR mt't <br />CITY ZIP PHONE STATE LICENSE F <br />fulli4e/c-Ii -tSo•i iys-qTly A"P. %.NiLUDLL <br />CITY ZIP PHONIi .STAW LfCENSI . <br />CLA.. U NORK ' <br />\AR1EW i i I.DDIT'OH A_TERAT'DN REPAIR DEMOLITION WOODSTOVE/FRPL INSERT ! BUILDIN3 RELOCATION <br />Pi OF WORK y,_(��,(= <br />CONTACT PERSON AND PHONE NO <br />� ��� ���I� <br />,D,EES�CCRRIBET/W�O/R�N�A�ND SOLAR E FOOTAGE I�DLVE� <br />� <br />PROPOSED USE OF SUILOINJ <br />2 I `k Ii Q <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 PROPERTY 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 />X 01 t(4193 <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT. BLOCK of ¢¢s.rv. TC ac <br />QLCCO .L'l(%, -k3 p\ dip blA $ 0a& <br />7� i�IA�a LO'S /LA.a.oL&A aE S.0 <br />F'-Le''T� <br />,,.:..Y, <br />- •:vI ¢ ✓ <br />OJECT ADDRESS <br />suwl— DATE <br />CITY BVSME49lILFN9C N(I <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />C—A HNDLG UNITS—H.P. <br />BATHTUB <br />' <br />F CED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <br />UNI EATERS—B.T.U. M <br />OWER <br />' <br />CLOT S DRYERS <br />_ <br />VENTILA ON FAN <br />' <br />RANGE H D <br />i <br />WATER HEAT <br />NDISP <br />R <br />I <br />WOOD STOVE <br />' <br />METAL FIREPLACE CHIMNEY <br />I <br />FIREPLACE INSERT <br />F'.00R DPAIN <br />' <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTE <br />i <br />OAS PIPING <br />i <br />ROOF DRAINS—RAINLEAD <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />' <br />.. <br />I <br />I <br />' <br />, <br />1 <br />SUB TOTAL $ <br />' <br />SUB TOTAL S <br />' <br />PERMIT $ <br />PERMIT $_ <br />TOTAL FEE E <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK A <br />LOTAREA C <br />—ZONE <br />.USE <br />=_ <br />TYPE OFCORIS ALLOWABLE <br />TYPE WCOOKS�II <br />mrc ru RI rro <br />NO OF STORIES <br />LOAD I FIRE <br />SIDE SETBAY1 <br />F BUILDING <br />aclnx.cv Ko aaYTuao aloe <br />' PLUMBING <br />BASEMENT MECHANICAL <br />ADDITIONAL PLAN CHECK <br />339 m 3 <br />ND <br />�i— <br />rllEi/ <br />MAKE <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLICWORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />0 <br />