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APPLICATIG .-"OR CONSTRUCT....." PERMIT jj <br />IRB EveYg+Ben TO BE COMPLETED IN INK -PLEASE PRINT <br />CITY OF <br />everett HEATING SYSTEM: U GAS ❑ ELECTRIC U <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING <br />PLUMBING SIGN <br />- MAIL ADDRESS CITY TIP PHONE <br />80E1N6 11/4I1 SAY ASSMIRLY Slog-fo_zs EvE�r.w�4. yt�l ZZ44640 <br />TENANT MAIL ADDRESS CITY ZIP PMONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY TIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSER <br />AUSnN C011NNY <br />/0/S- 47n, A <br />EVE+�iTAL✓A. 112oi <br />2"-"oo <br />Z23-01-AU•$r-1e73Wj <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />PHONE <br />LICENSER <br />40flo fl&6 OWE~ <br />/M 1,0 //7m+ <br />�AZ/IPE��A <br />A, NE AMAM I%# <br />9/4o9J 827-W,+ <br />coStoFftoNM <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY TIP <br />PHONE <br />LICENSE <br />ZG SOF WORK <br />NEW I ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT L; BUILDING RELOCATION <br />F• <br />CONTRACT PRICE OF WORK /{ OR// <br />CONTACT PERSON ANp PHONE Np <br />27-46 S <br />DESCRIBE WORK AND SOUARE FOOTAGE IAVOLVED <br />PROPOSED USE OF BUILDING <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 WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR ON AUTHORIZED AGENT DATE <br />�t'L_ •� <br />X ,NQ 41Z 7/9 s 4 <br />4C*tw A*f Agmto7oN # G2+l(v I <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIESI <br />LOT BLOCK OF <br />4V&TT i� n/AJCL /j OI.VS <br />yt v3 v <br />PROJECT ADDRESB <br />f <br />/J <br />C' <br />APPLICANTS CITY BUSINESS LICI.NSi. NO. ANDBU9NESSNAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />; <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />DRAINS-RAINLEADERS <br />_ <br />EXHAUST FAN <br />�. <br />_ROOF <br />SINK (SERVICE -BAR. ETC.) <br />TQX <br />S / <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />_ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAIT CHECK NUMBER <br />FEE <br />RECEIPT NO <br />3 �, s'_z .c` <br />3 S 7s' <br />7 76) <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />- <br />-- <br />TYPE OF CONTS ALLOWABLE <br />TYPE OF CONST ACTUAL <br />aNPAAt+ <br />IA aOMUIru;uxl5 <br />°A0w <br />PLUMBING <br />SIZE OF BUNG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />I <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRINKLERS REDO HEIGHT LIMITATION <br />REASON FUR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS PROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />s <br />