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APPLICATIC FOR CONSTRUCT )N PERMIT <br />Ine EYoTpreoR <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />HEATING SYSTEM: U GAS U ELECTRIC U <br />DEMOLITION I COMBINATION BUILDING <br />evt rett <br />e <br />PLUMBING SIGN <br />OWIILN MAIL ADDRESS CITY ZIP PHONE <br />r-IN4 8/4N SAY ASSCM&Y 8464 4o-ZS EvER.&rr,um. 7?wl ?26- 6(z <br />TENANT MAIL ADDRESS CITY .'.IP PHONE <br />ARCHIICCT OR DE9GNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZP PHONE LICENSE <br />AUSDN COHPAN`/ /0/S-47Ar 4yi/ W4. 98200 2G6-"aa 223-OI-AU•ST-I[737Jti <br />MECHANICAL CONTRACTOR MAIL ADDRESS WTf' ZIP PHONE LICENSE• <br />COSCv f/QE P1e0IFmN /09/40•//77,, a.N.E• k/RK~w A9 0Y Sa71441t4 CoSCOFP/loNM <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />CLASSOF WORK <br />NEW I ADDITION i I ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT Li BUILDING RELOCATION <br />CONTRACT PRICE OF WORK q —/Nk�F <br />CONTACT PERSON AND PHONE NO <br />AL S/IITI/ SZ7-gG SQ- <br />DESCRIBE WORK AND SQUARE FOOTAGE 1 VOLVED <br />M/DIMP-IuM AD /i7onl <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 CONSTRUCT;ON 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 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE // -7 <br />Alf X <br />usco twof /Karse-noN # o24-141+ <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR CCPIES) <br />LOT_ BLOCK OF _ <br />PROJECT ADDRESS <br />YQ S � <br />._— <br />APPLICANTS CITY COSINESS 4C::NSf NO AND UUSINEGS NAMC <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 BASH I) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHUWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRYTRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF- DRAINS—RAINLEADER_S <br />EXHAUST FAN <br />SINK (SERVICE —EAR, ETC.) <br />S / <br />— <br />SUB TOTAL $ <br />SUB TOTAL <br />_ <br />PERMIT $ <br />—_ PERMIT $ <br />-_ <br />TOTAL FEE S. <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHOCK NUMBER <br />FEE <br />RECEIPT NO <br />s -74 <br />��. � a <br />,.a <br />USE ZONE <br />LOT AREA <br />VACANT SIIE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— -- <br />--- <br />TYPE OF CONTS ALLOWABLE <br />TYPE OF CONST ACTUAL <br />O1~1 <br />401Y"IHH0UU6 <br />'Aw. <br />I <br />PLUMBING <br />' <br />T <br />_ <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />��// // •�, <br />ADDITIONAL PUN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS REDD HEIGHT LIMITATION <br />OTHER <br />REASON FOR SPRINKLERS 1 <br />1 <br />STATE BL ILD'NG SURCHARGE <br />INTAKE BY <br />1'L 'PROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TOTAL <br />iG <br />(I <br />TAX CODE IS 3105 <br />J <br />