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APPLICATIO.. FOR CONSTRUCTI.oN PERMIT ni* <br />TO BE COMPLETED IN INK -PLEASE PRINT <br />the EYnrgwr <br />CITY OF <br />everett HEATING SYSTEM: U GAS ELECTRIC CJ <br />BUILDING DEPARTMENT <br />259-8810 <br />_ DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITYY ZIP r, PHONE <br />\.Jo ZN Te-Y)''( r?1101 <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />i'�/�yF fT 1�IrJ1rFf�llrzQ <br />r' �iaZF wfTMsE <br />1`vLt <br />l tIP �i"�Ic�l <br />ARCHITECTORDESIGNER <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />el <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P <br />PHONE LICENSER <br />MECHA ICAL CONTRACTOR <br />MAIL ADDRE55 <br />CITY <br />21P <br />PHONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE A <br />CLASS OF WORK <br />ncAAnl ITIFN <br />WE)E)nSTOVE5FRPL INSERT BUILDING RELOCATION <br />NEW AUUII lull <br />CONTACT PERSON AND PHONE NO <br />I <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK ANDSOUARE FOOTAG; IN'�ED 3��T GrT <br />1r <br />i 1 J' I l sri t <br />/ !r= <br />/r Tr�,,, I Lot <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED USE OF BUILDING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�1 UK) / I� _r. I /� `- <br />BELOWOR ATTACH FouR COPIES) <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN <br />WORK <br />OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT_ BLOCK <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 PFRFORM 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 />ATURE OF CONTRACTOR OR AUTHORIZE GENT <br />]APP <br />PROJECT ADDRESS <br />LA S ITV BUI ICEN OAND ELFIN" AMEPLUMBING <br />CHANICAL <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />110. TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) <br />I <br />A/C—AiHNDLG UNITS—H,P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS--B.T.U. M <br />CLOTHES DRYERS <br />SHOWER <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER / <br />CLOTHES WASHER <br />WOOD STOVE <br />/ <br />METAL FIREPLACE 6 CHIMNEY <br />URINAL <br />DFI!NK,ING FOUNTAI <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP , <br />BACKFLOW P VEN (ERS <br />GAS PIPING <br />ROOF URA S—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (scRVICE—BAR. FTC.) <br />SUB TOTAL $ <br />SUBTOTAL $ <br />P <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTALFEE $ <br />FOH v"Il :t Ubt <br />FRONT SETBACK <br />USE zoN <br />- <br />UNLT: <br />REAR SETBACK <br />S-n,JG— <br />LOT AREA <br />SIDE SETBACK <br />VACANT SITE <br />A) <br />PL/NCITE KNUMBER FEE <br />yr <br />FEES <br />VALUATION <br />RECEIPT NO <br />FEE <br />BUILDINS go ooe <br />_ y,/ A/ .ra <br />TYPE ITT CONTS ALLOWABLE <br />TYPE 01 CONS ACTUAL <br />(XCa— <br />x00�bMIIix4 u•urs <br />PLUMBING <br />MECHANICAL <br />SIZEOF BLDG NO. OF SIORI S BASEMENT <br />�,�vv fr i Loa Sf <br />OCCUPANCY LOAD FIRE SPRAN�KfLERS REOD HEIGHTLIMITATIONaIo <br />Z 0 li x i l <br />REAS 21PAINKLERS <br />ADDITIONAL PLAN CHECK <br />r/ X1 <br />OTHER <br />STATE BL'ILD'yG SURCHARGE <br />PUBLIC WORKS <br />INTAKE BY <br />PLANS APPROVE OBY' <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />/09 9J <br />