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APPLICATII&A FOR CONSTRUC &N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 9259.8810 <br />n DEMOLITION `'l COMBINATION Fl BUILDING Fl MECHANICAL 11 PLUMBING lxsIGN <br />PROJECT ADDRESS N/ // / /oz <br />PHONE <br />MAR <br />CONTRACT PRICE OF W0 <br />HEATING SYSTEM: Cl GAS fl ELECTRIC n <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE <br />L <br />drc, e k, 01, <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 1 COMPLY WITH THE STATE <br />CONTRACT W 18.27 R D 296.200 WAC. <br />X CI /7-? -95- <br />PROPOSED USE OF BUILDING <br />Q <br />e <br />LEGAL -DESCRIPTION OFPROPERTY (SHOWN BELOW ORATTACHTWO COPIES) <br />LOT' BLOCK OF <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LEND R. ADDRESS. TELEPHONE NUMBER <br />_ <br />SIGNATURE DATE <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 />WATER CLOSET (TOILET) <br />' <br />A/C —A/HNDLG UNITS—H.P. <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <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 />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />i <br />RANGE HOOD <br />i <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />' <br />' <br />GAS PIPING <br />i <br />EXHAUSTFAN <br />1 <br />I <br />I <br />' <br />SUBTOTAL $ <br />; <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT $ <br />' <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />2 <br />2 <br />USE ZONE <br />IOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />J <br />C, <br />/� O <br />ES Li NO <br />H51�FIT LIMITATION <br />NO. ING <br />SIZE OF BLDGITI. <br />' <br />AP <br />PLUMBING <br />MECHANICAL <br />i <br />OCCUPANCY NO OE STORIES <br />OCCUPANT LOAD BASEMENT <br />CROUP <br />I <br />FIVES 11 NO <br />' <br />ADDI110NAL PLAN CHECK <br />' <br />FIRE ALARM RED <br />REASON <br />i <br />OTHER <br />I <br />FIRE SPRINKLER REDD <br />REASON <br />/i <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />I <br />TYPE OF CONST <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TOTAL <br />/ I190 <br />; <br />TAX CODE IS 3105 <br />1 <br />,� <br />DAZE <br />