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APPLICATIOTA FOR CONSTRUCT N PERMIT <br />i ow Fwromon <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK --PLEASE PRINT <br />❑ DEMOLITION I I COMBINATION 1 BUILDING I I MECHANICAL I PLUMBING <br />OWNER 4AIL ADDRESS CITY ZIP PHONE <br />?l^o I�(o po &,x .120 N'/t CW-z ( Sndff(e k2o—sk S90 <br />TENANT MAILADDRESS CITIZIP PHONE <br />1 � &_Cl� <br />ARCNITECSAT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />CITY AIr r•nvne <br />MECHANICAL CONTRACTOR MAILADDRESS CITY nr rnorlr ul.ii e. <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />rl Now f -I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVEJFRPF_ INSERT I I BUILDING RELOCATION <br />TENANT PRPROVEMENT OR INTERIOR REL ONLY <br />MCQ�)E <br />CONTRACT PRICE OF WORK! Ay O S M It­,z' <br />CONTACT PERSON AND PHONE NO <br />DESCRIBE WORK AND SQUARE FOOTAGE I VCLVEn <br />//,n T'// <br />PA14IAia- on 7 e1!'krat 2U4 <br />PROPOSED USE OF BUILDING i <br />�Se r,, <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 />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 PERFORM THE WOPK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />S NATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />x SPP DNAJI��(1nhh1 <br />LE•'ALL DESCRIPTION OF PROPERTY IBHOWN Lowo ATTACH FOURC ONE, <br />LOT BLOCK OF <br />PFLOIECT ADDRESS <br />iAxl t j <br />PLUMMI Ni JCJI/J/ <br />APPLICANTS CITY BU&NE L ENSE NO. AND bU5WE83 NAME <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE Oil ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC —A HNDLG UNITS—H.P. <br />1 <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />; <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />1 <br />WOOD STOVE <br />_ <br />URINAL' <br />' <br />METAL FIREPLACE A CHIMNEY <br />; <br />DRINKING FOUNTAIN <br />_ <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />_ <br />�_ <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />; <br />I <br />T� <br />1 <br />I <br />SUB TOTAL E <br />SUB TOTAL S <br />I <br />PERMIT <br />--T_ <br />PERMIT $ <br />r <br />T <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />FRONT SETBACK <br />REAR SETBACK <br />SICE SE78ACK <br />FLAN CIIEC� NUMBER <br />FEE <br />RECEIPT NO, <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />I I YES I I NO <br />VALUATION <br />FEE <br />_FEES <br />BUILDING <br />.--- -- <br />PLUMBING <br />TTPFAF CONST ALLOWABLE <br />-�' <br />TYPE Of CONST ACTUAL <br />JF� <br />P[CIPYCr <br />-Z <br />Ip a mfUls"uxm <br />' <br />SIZE OF BLDG <br />yrj?� x►" <br />_ <br />NO OF STORIES <br />RASLN2NT <br />I YES I NO <br />_ <br />FAECIIANICAI <br />----- <br />OTHER <br />---- <br />1 <br />OCCUPANCY LOAD FIRE SPA KLERSREOD HEIG14T LIMITATION <br />I I YES }X NO ZD ;' S ( <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />L- j5 <br />-- <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />i <br />TOTAL <br />SrJ <br />A <br />