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APPLICATIO. 4 FOR CONSTRUCT►JN#JAN <br />CITY OF EVERETT • BUILDING DIVISION 3200 CEDAR STREET a EVERETT, WA 98201 e259.8810 2 Q <br />......... . <br />� ...i <br />IGN <br />l DEMOLITION f l COMBINATION BUILDING MECHANICAL CI1gLl�jllj�` —i <br />PROJECT ADDRESS Mud ' rLIDlic Works Dept. I <br />8017 Beverly bocce, Everett, WA <br />OWNER MAIL ADDRESS CITY ZIP 1111VYn <br />tiarsen-Construction----1i802---23rd-Street 1 fi G ^h <br />TENANTn / MAIL ADQRESSI -.� ✓.�(e. dA / CITY ZIP PITONE �-//`1��, <br />i i J % YlJrr i i09 r �e n l' '62LI �7 `Y / <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />CITY <br />S.W. <br />ZIP <br />Lynnwood 98037 <br />PHONE <br />745-3930 <br />STATE LICENSE <br />HORIZHI137DU <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />Horizon Heating, <br />Inc. 3601 - <br />121st St. <br />11 WRING -CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: XI GAS ❑ ELECTRIC ❑ <br />$33350.00 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE N0. <br />Robert MacGregor 745-3930 <br />Furnace installation and gas piping <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 ORDINANCES GOVERNING THIS TYPE OF <br />BUILDING <br />PROPOSED USE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LEGAL DESCRIPTION <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK of <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 />CONTRACTO S LAW 18.27 RCW AND 296.200 WAC. <br />1/13/95 <br />CIy D. NUMBER <br />CONSTRUCTION LOA, ._NDER, ADDRESS, TELEPHONE NUMBER <br />X DATE <br />SI E <br />CITY BUSINESS LICENSE NO. <br />MECHANICAL <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />' <br />/ <br />A/C — A/HNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS —B.T.U. M E.A. <br />' <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />' <br />I <br />' <br />' <br />, <br />' <br />' <br />I <br />' <br />' <br />' <br />, <br />HEAT PUMP <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT (WOOD BURNING) <br />GAS FIREPLACE <br />' <br />' <br />�— <br />( <br />' <br />' <br />' <br />, <br />' <br />' <br />' <br />' <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />OAS PIPING <br />I ' <br />EXHAUSTFAN <br />' <br />, <br />, <br />I <br />I <br />' <br />SUB TOTAL $ <br />80 i00 <br />SUB TOTAL $ <br />PERMIT $ <br />15 '00 <br />PERMIT S. <br />TOTAL FEE S <br />95 '00 <br />TOTALFEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FROM SETBACK REAR SETBACK <br />LOTAREA <br />HEIGHT LIMITATION I NO, OF DWELLING <br />UNIT <br />LOAD <br />SIDE SETBACK (PLAN CHECK <br />VACANT SITE <br />n YES TT NO <br />SUILD'NG <br />SIZE <br />OF BLDGIT I. <br />PLUMBING <br />BASEMENT <br />MECHANICAL <br />❑YES n NO <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE PUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />FEE I RECEIPT NO. <br />