Laserfiche WebLink
APPLICATIGA FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />I FMOLITION I I COMBINATI N I BUILDING MECHANICAL 1 1 PLUMBING I SIGN <br />PROJECT ADDRESS � I p wok ci V 2 O I <br />d-1�� <br />OWNFR MAIL AODPmESS� KL (� /Y CITY ]IP PHONE <br />n Iry t*t�.'IF bwrtt} 120l 259 - CoO� �L 1 <br />TENANT MAILADDR.SS CITY lIP PHONE <br />ARCHITECT OR DESIGNER VAIL ADDRESS COY ZIP PHONE <br />CONTRACTOR MAIL ADDRESS CITY III' PIIC`JE STATE LICENSE <br />GENERAL <br />Mz /�css CGAs�, <br />•� <br />Y.O.6o,c <br />hit a ara <br />1i�°Zg �85 orbs& M"3 �.1Csc�CzS31�� <br />M`FCHANICALCONIFIACATIO�R t <br />J6hO.lA1�.A 1��G6. <br />MAIL ADDRESS <br />Z, O%oa <br />'1 CITY <br />l'i�i�` A•n. N.C- uJec��wllo <br />ZIP PHONE STATE LICENSE <br />I�72-hi-21G6 <br />PLUMBING CONTRACTOn <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE STATE LICENSED <br />CONTRACT PRICE OP WORK <br />UOU <br />HEATING SYSTEM: Cl GAS 11 ELECTRIC f 1 <br />DESCRIBE WORN AND SQUARE FOOTAGE <br />CONTACT PERSON AND PHONE NO. <br />�NVOL i Dry % <br />A� �Xanr✓s� r,�ti •� . Pc✓s <br />- � <br />.� <br />P/� <br />V67 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />04 K 'f" 6101(C, <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />PROPOSED USE OF BUILDING <br />'0 O) <br />(ite/, V `+` ele/c 774� 1 - t4 n°w <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LFr.I, DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />L BLOCK eF <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 10.27 RCW AND 296.200 WAG. <br />PARCELTAXID. NUMBER <br />X /�w^^ <br />NUMBER <br />CONSTRUCTION LOAN LENDEn. ADDRESS. TELEPHONE <br />- <br />SIGNAI0nE DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C—A/HNDLG UNITS — H.P. <br />BATHTUC <br />' <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />' <br />DISHWASHER <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />' <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />, <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />; <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />" <br />EXHAUST FAN <br />I <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT S <br />PERMIT S <br />_ <br />TOTAL FEE S <br />' <br />TOTALFEE <br />T <br />rum vrrlvc vow vLa-I. <br />FRONT SETBACK <br />nEAR SETBACK <br />SIDE SETBACK <br />NUM <br />PLAN CHF^K FR <br />FC.E <br />PFCEIPT NO <br />�19bo1. <br />FEES <br />VALUATION <br />FEE <br />USE ZONE <br />LornnEA <br />VACANT SITE <br />n YES n NO <br />BUILDING <br />i <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDG71 <br />' <br />' <br />UNITS <br />PLUMBING <br />I- <br />MECHANICAL <br />I <br />i <br />OCCUPANCY J CT STOP ES <br />OCCUPANTLOAD <br />BASEMENT <br />GROUP <br />nYES FI NO <br />i <br />ADDITIONAL PLAN CHECK <br />' <br />' <br />FIRE ALARM BEG <br />TREASON <br />I <br />OTHER <br />I <br />FIRE SPRINKLERREO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />' <br />PUBLIC WORKS <br />TYPE OF CONST <br />PIANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />1 <br />-14,117o <br />TAX CODE IS 3105 <br />1 TOTAL <br />' <br />DATE <br />