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1 <br />C: <br />I <br />_ <br />... j <br />a <br />u <br />IAI Emigwn <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />APPLICj4fION FOR CONSTROaTION <br />PERMIT <br />I•\ICI I.II <br />el <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />t <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />A <br />❑ ❑ AL TERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT U BUILDING RELOCATION <br />❑ NEW ADDITION <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTRACTPRICEOFWORK <br />CONTACT fMiRSW AND PHONE ME, <br />—- <br />DESCRIBEWORKANDBOUAREFOOTAGEINVOLVED <br />PNOPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HA%S READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERN ING THIS TYPE OF WORK WIL L BE COMPLETED WITH <br />WHETHERSPECIFIED HEREI N OR NOT. THE GRANTING OF A PERM IT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE DIANER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />296.200 WAC <br />SIGNATURE JFF CA4TPAcTon oR AUTHORIZED AGENT RATE <br />X gllW <br />LEGAL DESCRIPTK)N Of PROPEPTYISHOWN BELOW OR ATTACH FOUR COPIESI <br />LOT BLOCK OF <br />_ <br />PPOJECT ADGPEBS q <br />g003 UJ• CifSiAro /�ql <br />p <br />par yn o0 <br />APPLICA CITY BUSMEBSL CDBUBINESS NAME <br />PLUMBING <br />MECHANICAL . <br />NO <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />A/C - A/HNDLG UNITS - HP. <br />BATHTUB <br />FORGED AIR SYSTEMS- STILL M EA <br />LAVATORY (WASH BASIN) <br />too <br />UNIT HEATERS -ST.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK6 DISP. <br />Ci <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />p <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />toFIREPLACE <br />INSERT <br />_ <br />FLOOR GRAIN <br />' <br />HEAT PUMP <br />DACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS — RAINLEADERS <br />(J <br />EXHAUST FAN <br />At <br />SINK (SERVICE —BAR ETC) <br />S <br />SUB TOTAL <br />S <br />S,; <br />SUB TOTAL _ _ _ S <br />PERMIT <br />S <br />�O <br />PERMIT $ <br />TOTAL FEE S <br />PLAN CHICK NUMBER FEE RLClIR NO. <br />TOTAL FEE i <br />FRONT SETBACK REARSETIMCA SIDE SETBACK <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />DYES 0 NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />- <br />1YPE OF CONST. <br />ALLOWABLE/ACTUAI <br />OCCUPANLYGNOUP <br />NO OF DWELLING UNITE <br />PLUMBING <br />SIZE OF SLOG <br />NO OF STORIES <br />BSMT <br />DY <br />ON <br />OLL LOAD <br />HEIGHT LIMITATION <br />MECHANICAL <br />OTHER <br />_ <br />FIRE SPRINKLERS REWIRED 0 YES 0 NO <br />STATE BUILDING SURCHARGE <br />APPLICATION ACC BY PUNS ATMNl er <br />STATE ENERGY SURCHARGE <br />PUBLICWORKS <br />TOTAL <br />— <br />0 <br />