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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 A259-8810 <br />fl DEMOLITION 11 COMBINATION I I BUILDING MECHANICAL 11 PLUMBING Xl SIGN <br />PROJECT ADDRESS 2U I <br />ER MAIL ADDRESS CITY 11P PHONE <br />ARCHITECT On DESIGNER MAIL ADDRESS r-�TY /IP PHONE <br />I I. �'ti .`� �.. inn 5w I/ 7.t <br />PHONE <br />PLUMBING CONTRACTOR MAILADDRESS CITY ZIP PHONE STATE LICENSE <br />- g/-0? <br />CONI Cy PF RK <br />rj y <br />�� <br />HEATING SYSTEM: GAS ❑ELECTRIC <br />_IF <br />SCRIBE A tOUAREFOOTAGE OLVED <br />CONtACTPFRSONANUPIIONENO <br />- 06 <br />//�� /- <br />ok /' U %i-- <br />Lour �. <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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION 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 />7\RRCW\ AND 296.200 WAC. <br />MCONTRACTORS LAW 18.21�. <br />\ \ \�o 12, IS—q(� <br />1 <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />SIGNAT nEnET DATE <br />0 <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />NC — AMNDLG UNITS — H.P. <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />I ' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />; <br />KITCHEN SINK 6 DISP <br />i <br />CLOTHES DRYERS <br />i <br />DISHWASHER <br />' <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />RANGE HOOD <br />i <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR. ETC.) <br />I <br />GAS RANGE <br />' <br />GAS PIPING <br />EXHAUST FAN <br />' <br />I <br />' <br />I <br />I <br />' <br />' <br />SUB TOTAL <br />E <br />SUB TOTAL E <br />O i <br />PERMIT <br />E <br />I <br />PERMIT $ <br />l� ' <br />TOTAL FEE <br />S <br />�— <br />TOTAL FEE E <br />�nA nCCIPt LIQO nul V. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CIIFCK NUMB11 <br />FEE <br />RECEIPT NO <br />Z4& 5 <br />USEZDNE <br />LOTAnEA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />11YES IT NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGRI <br />' <br />UNITS <br />PLUMBING <br />' <br />OCCUPANCY NO OF STORIES <br />OCCUPANTLOAU BASEMENT <br />MECHANICAL <br />GROUP <br />❑YES n No <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM AEGD <br />REASON <br />OTHER <br />FIRE SPRINKLER RED 0 <br />REASON <br />STATE BUB DING SUNOIMRGE <br />TYPE OF CONST. <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />