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APPLICATItod FOR CONSTRUCT ION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 9B201 •259-8810 4wff <br />F- DEMOLITION F COMBINATION I-1 BUILDING Fl MECHANICAL PLUMBING Fl SIGN <br />PROJECT ADDRESS <br />OWIF.R MwIL A'ORESS CITY ZIP PHONE <br />TENAK M4AODRE55 ITVT21P PHONE <br />ARCIInE.^.'OR DESIGNER <br />MMA ADDRESS <br />CITY ZIP <br />PHONE <br />GENERAL'^ -TRACTOR <br />v ]LADDRESS <br />CITY ZIP <br />PHONE <br />STATE LICENSE • <br />MECHANICAL ...NIIAIII <br />�LssdnlA�L <br />o+RAD11E55 <br />Tlc. 7r7.pCXaIg <br />CITY ZIP <br />C/IlUUA7coJ %8�/y <br />p110NF. <br />�a�}333—Yrs3 <br />STATE LICENSE. <br />���GEP 19gPG <br />PLU MBING CClrq CTOR <br />'TAILADDRESS <br />CITY ZIP <br />PHONE <br />STATE LICENSE. <br />CONTRACT 1 `ICE OF Wp, <br />HEATING SYSTEM: I 1 GAS n ELECTRIC <br />Fl <br />DESCRIBE WORK AND SQUARE FP'AGE INVOLVED <br />�o%�IPL,rTE �u,,; VIZ�G .g�_`il- <br />CONTACT PERSON AND PHONE N0. <br />Epmrjr •Fttralnl/ <br />Jvj <br />PROPOSED USE OF BUILDING -- _ <br />_ <br />LEGAL DESCRIPTION OF PROPERTY IOWO ArTACNI%�I fit.. _ <br />LOT BLOCK _ _ OF <br />_ <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 AIJD I COMPLY WITH THE STATE <br />CONTRACTORS LAW <br />/188.%277 RCW AND 296.200 WAC. �y <br />X ( l/, D/'( 6 <br />- <br />PARCEL Tft i <br />CONSTRUCHUNLOANLENUL,T� Atim-RS.TBLEpNONtlI I Ph <br />SIGNATURE YOAT <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />a <br />WATER CLOSET(TO'LET) <br />A/C -A/HNDLG UNITS -H.P. <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />; <br />;2- <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />, <br />SHOWER <br />' <br />UNIT HEATERS - B.T.U. M <br />/ <br />KITCHEN SINK 8 DISP <br />; <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />VENTILATION FAN <br />I <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />' <br />CLOTHES WASHER <br />WATER HEATER. <br />I <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />; <br />FLOOR DRAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />' <br />SINK (SERVICE - BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />i <br />EXHAUSTFAN <br />i <br />I <br />SUB TOTAL S <br />SUBTOTAL $ <br />PERMIT $ <br />I <br />PERMIT $ <br />i <br />TOTAL FEE $ I <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />flYES 11 NO <br />- <br />OIIILC:NG <br />HEIGHT LIMITATION <br />NO OF OWELUNG <br />SIZE OF BLDGRI <br />, <br />UNITS <br />PLUMBING <br />i <br />OCCUPANCY <br />NO Of STORIES <br />OCCUPANT LOAD BASEMENT <br />I <br />GROUP <br />I <br />MECHANICAL <br />I1 YES Il NO <br />ADDITIONAL PLAN CHECK <br />I <br />T <br />FIRE ALARM REOD <br />REASON <br />0114EA <br />FIRE SPRINKLER REO'D <br />REASON <br />STATE BUILDING SIIRCIIMC,E <br />i <br />TYPE OF C.ONST <br />PLANS APPPOVED BY <br />CITY OF EVERETT <br />PUBLIC, WORKS <br />LOCAL SALES <br />�— <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />I <br />