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APPLICATION FOR CONSTRUCTION PERMIT E•VL'TP11 <br />the Ewrgr"n TO BE COMPLETED IN INK -PLEASE PRINT <br />CITY OF <br />everett <br />BUILDING DEPARTMENT F—HEATING SYSTEM: U GAS U ELECTRIC <br />- <br />259-8810 <br />DEMOLITION COMBINATION BUILDING -MECHANICAL PI AGING _ SIGN <br />OWNER MAIL ADDRESS COY ZIP PHONE <br />so <br />01" /1/*# SAY .4Z&48" 0_4o-as Eve�arr.w�. 9��I IZ�-1Gl.Cb <br />TENANT MAIL ADDRESS CGV ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY bP PHONE <br />GENE PAL <br />C0MPANY <br />ADDRESS CITY <br />/0/f-47a 4 f�E+tAMAIA. <br />ZIP <br />992011 <br />PHONE <br />Z6L 66w <br />LICENSE( <br />223�01-AU• ST--/ t73M.1 <br />MECHANICAL CONTRAC70R <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />LICENSE <br />COfCo fift j orfcnW <br />M9/O-/177r X.N.F. <br />PRA'HM sof 980y <br />8t7-14a4 <br />Cof[OfPIIoNM <br />PI UMBWG CONTHAC FOR <br />MAIL ADORE SS CITY <br />ZIP <br />PHONE <br />LICENSE <br />C S OF WORN <br />NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEIFRPL INSERT .. , BUILDING RELOCATION <br />r�RG <br />CONTRACT PRICE OF WORK A PRiNkG <br />CONTACT PERSON AND PIGNE NO <br />L SN�TII 827-96 f+ <br />DESCRIBE WORK AND SOUARE FOOTAGE IAIFOLVED <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 CORRECr. 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 1 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 />SIGNATUREOFCONTRACTOROHAU7HORREUAGENI DATE <br />x � s�co_fAe now* IOZ+lG I¢ <br />------ ----- <br />PPLICAN I SOTY BUWIla 5S 1.0. NSF NJ AND U:nu.E iS NNAE <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES( <br />LOT_ BLOCK OF <br />FwFZonr 6 13 <br />PROTECT ADDRESS . i <br />P{ —n--F <br />/ <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-AIHNDLG UNITS-H.P. <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />-T- <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />RCAF DRAINS -..RAINLEADERS <br />_ <br />EXHAUST FAN <br />SINK (SERVICE. -BAR, ETC.) <br />_ <br />SUB TOTAL f <br />SUB TOTAL <br />PERMIT f <br />PERMIT f <br />TOTALFEE f <br />TOTAL FEE f <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN C2H)ECK NU IOEP <br />FEE <br />NE EIPT NG <br />USE ZONE <br />LOT AREA <br />VACANT SHE <br />_— <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />-----—'---------'-- <br />PLUMBING <br />fYPEOFCONISAIIOWABIE <br />TYPE OF CONSIACEAL <br />IKrVNArLr <br />1R01'" <br />Ml H uwr.uw. ubT$ <br />BME OF BLDG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />OCCUPANCY LOAD FIRE SPRINKLERS RED HEIGHT LIMITATION <br />HEASpI FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />T <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />