Laserfiche WebLink
APPLICATILA FOR CONSTRUCT,ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION 4T*7r <br />2r0 CEDAR STREET • EVERETT. WA 98201 • 959.8810 <br />nCANn11T1nA1 n PnRARIKIATInN IV RUILOING ❑ MECHANICAL V- PLUMBING ,YSIGN <br />3ROJECT ADDRESS ON I'VgyqreQ� O4�, <br />wucn MAILADDRESS CITY ZIP PHONE <br />MA LADDRESS TY ZIP PHONE <br />TEN N <br />., T A. is J.. I I c ._ d Oki v-j <br />ARCHITECT OR CES R <br />M DDRESS <br />CITY <br />ZIP <br />PHUNt <br />SL?I/VR.QS <br />JPC. <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />^. <br />& <br />S17 8otAf11 <br />CM1217_ <br />7yr-9Cg� <br />i2dCON1Hk0ELGN <br />MMEECCHhrICAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />PLUMBING CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />CONTRACT PRICE oFWORK _ <br />HEATING SYSTEM: fN GAS ❑ ELECTRIC ❑ <br />DE CRIOE IORK ANO SQUARE FOOT GEINV <br />CONTACT PER ON AND PHONE NO. <br />N'p <br />„ Q <br />31 11 <br />i <br />(,L/i'FJTU <br />I <br />�nn7^NI ' <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 ORDINAVCES GOVERNING THIS TYPE OF <br />OF BUII�I'NG <br />PROPOSED USE l <br />, <br />tj 1 L raF�r » o !} <br />WORK WILL BE COMPLIrO WITH WhETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION FPROPERTY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF ' <br />'D <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OR THE <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />f•, 1 <br />10 <br />/ <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 />- LCGi n i+9 IQ P G va <br />/1 QLo,.,�f Lgd '�' VOl TL D i <br />TI4-if <br />D✓ ' Y GI/� & ' 41. +7 �'.1 <br />Z14o _n <br />4 <br />_ i! <br />CONTFFq TORS LAW 18.27 RCW AND 296.200 WAC. <br />PARCEL TAX IQ U IBE <br />a� DoG d <br />• <br />CONSTRUCTION LOAN LENDER. ADORES-, TELEPHONE NUMBER <br />X <br />SIGNATURE 'DATE <br />t of <br />383/ <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />I <br />— A <br />A/C/HNDLG UNITS — H.P. <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS —B.T.U. M <br />KITCHEN SINK & DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />; <br />LAUNDRY TRAY <br />i <br />RANGEVENTILATION <br />HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />' <br />URINAL <br />WOOD STOVE <br />DRINMNG FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />'Z <br />BACKFLOW PREVENTERS <br />/ <br />GAS FIREPLACE <br />SINK (SERVICE — BAR. ETC.) <br />1 <br />GAS RANGE <br />' <br />' <br />GAS PIPING <br />EXHAUSTFAN <br />' <br />) <br />I <br />� <br />SUB TOTAL <br />S <br />SUB TOTAL S <br />PERMIT <br />S <br />2 ej; <br />PERMIT S <br />' <br />TOTAL FEE <br />S <br />_ <br />' <br />TOTAL FEE S <br />' <br />rvn vrrlvc vJL VI�1.... <br />FRONT SETBACK / <br />rU <br />USE ZONF.F <br />REAR SETBACK' <br />O <br />LOTAREA <br />SIDE SETBACK <br />i <br />VACANT SITE ! <br />n YES ^I No <br />PLANCHEC Nu Eq FEE <br />'OA,,//,TT// <br />FEES <br />VALUATION <br />RECEIPT NO. <br />FEE <br />BUILDING <br />HEIGHT UMIT ION, <br />NO, OF DWELLING <br />UNITS / <br />SIZE OF BLDGR.L <br />PLUMBING <br />' <br />' <br />MECHANICAL <br />I <br />OCCUPANCY NO OF STORIES <br />G P <br />Q <br />UPANT LBADT ^ <br />I! L- <br />r GF I I <br />BASEMENT <br />ES n NO' <br />ADDITIONAL PLAN CHECK <br />I <br />FIRE ALARM REOG <br />I` <br />REASON <br />GTIIER <br />� <br />FIRE SPRINKLER REO'D <br />A <br />REASON <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />I <br />TYPE OF CONST. <br />PLANS APPROVED- <br />CITY OF EVERETT <br />U n <br />DATE O <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />I <br />7 <br />