Laserfiche WebLink
APPLICATI& FOR CONSTRUCN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 04L <br />I I DEMOLITION COMBINATION BUILDING YIECHANICAL PLUMBING i I SIGN <br />OWNER <br />MALAD ESS <br />9 L .— 'Elt <br />c ��'uve.��JJ <br />ZIP PHONE <br />lNI fht�41 <br />dnNl� <br />.�(_�'l_ <br />AN <br />``•• ,,�,E�,,.� <br />MAILADDRESS <br />I crtr <br />ZIP rl rvE <br />ARCHITECT OR DESIGNER <br />MAR ADDRCSc/ <br />LIIV <br />ZIP PHONE <br />GENERALCONTRACTOR <br />MAILADDRESS <br />CITY <br />;Ir PHONE <br />STATE LICENSE, <br />AN,YANICALCONTRACTOR <br />AA- A _ _ .. <br />MAILADDRESS <br />E,ITV <br />ZIP PHONE _ <br />ST(.TE LICENSE• <br />_ ' <br />CITY ZIP <br />�b / �Gf QL�� HEATING SYSTEM: i 1 GAS I 1 ELECTRIC fl <br />DESCR�I E WOR—K AIaD SOUARE FOOTAGE INVOLVED CONTACT PERSQN AND r110NE t14 <br />JAr�r/►f� L� 3 mA� ��EaD��C�iE.Ilki��10� N'J l,1rD1�►4�/1 %(p7 <br />F/l��%�lN 17aq-r �`J, <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 COMPLIED WITH WHETHER SPECIFIED HEREIN ORNOT. THE GIANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY 70 VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRU 3TION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWN_R OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON1 R nORS LAW 10.27 RCVV AND 296.200 WAC. <br />PROPOSED USE OF BUILDING <br />mofj �- <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIESI <br />LOT BLOCK _ OF <br />PARCEL TAx To. NUAIeER <br />CONSTRUCTION LOAN LENDER, ADORE: SS TELEPHONE NUMBER <br />S G rJFtyy DATE <br />P) i <br />CITY BE SPIESS LCENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />A/C — AMNDLG UNITS — H P. <br />I <br />BATHTUB <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />I <br />UNIT HEATERS — BTU. M <br />KITCHEN SINK 8 DISP <br />_ <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />I <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />T <br />URINAL <br />I_ <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WCOD BURNING) <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />I <br />i <br />- <br />I <br />SUB TOTAL $ <br />—-i <br />SUB TOTAL <br />PERMIT S <br />PER S <br />TOTAL FEE $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />ACK <br />PLAN CHECK NUMBE <br />FFE <br />RECEIPT NO <br />USE ZONE: <br />LOTAREA <br />TE <br />ESVALUATION <br />FEE <br />;VACANT <br />n NOBUILDING <br />NEIGNT HMITATION <br />NO. OF DWCLLING <br />SIZE <br />UNITS <br />PLUMBING <br />I <br />OCCUPANCY <br />NO OF STORIES <br />OCCUPANTLOAD <br />BASEMENT <br />I <br />GROUP <br />MECHANICAL <br />I <br />I <br />❑vcs n No <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM RED <br />REASON <br />OTHER <br />i <br />FIRE SPRINKLER RED <br />REASON <br />STATE BUILDING SURCHARGE <br />I <br />TYPE OF CONST <br />PLAN AprROVeDBY <br />CITYOF EVERETT <br />rueuc WORKS <br />LOCAL SALES <br />— <br />TOTAL <br />; <br />oATE (, _Sd <br />TAX CODE IS 3105 <br />