Laserfiche WebLink
APPLICATI�M FOR CONSTRUCT,�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS U ELECTRIC U <br />259-8810 � <br />!_l DEMOLITION I; COMBINATION I J BUILDING :"'fuIECHANICAL I_I PLUMBING � 1 SIGN <br />OWjJER ` R1�ILAOQRESS /_ CITV Zln PHONF. <br />��� // i)� � � <br />ARCHRECTORDEStGNGN MALL <br />PLUMBINGCONTFACTOR MAI�AD�fiE55 <br />CONTRACT PRILE OF WOFiM /(7 �G _ <br />���— c — <br />DESCRIBE WOPK AND SOUARE FOOTAGE INV <br />�i . -7: <br />�s <br />PPOPOSE� I1SE OF pUIL01NG <br />LE WL DESCRIPTION OF PROPERTV �SNOWN BELOW OR �TTACH TWO GOPIES) <br />�or o�ocK oF <br />P�flCELTAXIA NUMBER <br />NO. <br />ADDRESS, <br />i <br />WATER CLOSET <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN _ <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS--RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FRONiSEi�ACN �EAR SETBACK <br />115E ZONE <br />IYPE 01 CON57. <br />SRE Of BLDG. <br />OCCUPANCYLOAD <br />REASON <br />INTANE OV <br />SUB TOTAL $ <br />PERMIT $ <br />TOTALFEE 5 <br />FIRE SPRINKLEflS REO'D <br />FlRE ALt.PM fiE00 <br />PLANS MPqOVE� BV <br />UAT[ '/L�L%Il2 <br />CI1V � � 7.IP <br />CITY <br />`7'75 -�357� <br />ZIP PMONE <br />�/.�5"�9,Z3 <br />S AIEIIGENSE� F%'.(LIC�-�,I i� J <br />� 9��os.� <br />srn.e ucer+sE. <br />STqTE LICENSE • <br />JNTACT P ON D PHONE NO � � <br />`�°'�c.c:� c/.. ,�,��r";.�.���— <br />77s - js�7 <br />1 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 REVULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR�2ED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />X�);G;�l�-�f�,�._ 9-a�-;�� <br />scv�ruar wrz <br />Cliv O151Y[65 LICE NS[ NO <br />MECHANICAL <br />N0. TYPE OFEOUIPMENT FEE <br />A�C—AMNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN ' <br />RANGEHOOD ' <br />WATER HEATER <br />VJOCD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />$IDE SETBACK PL�N CHECK NOMBLR FEE <br />vncnNrsrtE FEES <br />i�. YES . 1 NO BUILDING <br />M.'.u�evn xoo�ow[u!ucuois <br />LP0°° I PLUMPING <br />—�— <br />BASEMENT MECHANICAL <br />�=' YES C NO <br />NEIGHT LIMITATION ADUITIONl11. PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHAFGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 rora� <br />SUB TOTAL $ ��1; <br />PERMIT $ /� � <br />TOTAL FEE 9 7 i ! <br />