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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />FI DEMOLITION f I COMBINATION FT BUILDIN!g I-1 MECHANICAL I 1 PLUMBING fl SIGN <br />PROJECT ADDRESS Q� / s <br />MAI RESS CITY 21P P ONEE /% <br />q <br />7IP <br />GENERAL CONTRACTOR MAIL ADDRESS CITY )IP PHONE STATE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE r <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: I l GAS f-i ELECTRIC fl <br />DESCRIB A FOOTAGE IXVOLVEO <br />CONTACT PERSON AND PHONE NO <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 />CONT TO LAW 18 RCW7ANZgZ6.2OOAC. <br />�� <br />95X <br />PROPOSED USE UIL G <br />' <br />LEGAL DESCRIPTION dt P06IFEATY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAX I.D. NUMBER n <br />3�� <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <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 />,� <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />I <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />_ <br />DISHWASHER <br />' <br />iff <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />; <br />_� <br />RANGE HOOD <br />CLOTHES WASHER <br />' R1 <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />' <br />Q� <br />! DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) a <br />i <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />E ' <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE F <br />SINK (SERVICE — BAR, ETC.) <br />' IJ <br />GAS RANGE <br />' 11 <br />GAS PIPING <br />EXHAUST FAN <br />I <br />I <br />�I <br />SUB TOTAL $ <br />II�_ <br />SUB TOTAL $ <br />; <br />PERMIT $ <br />I <br />PERMIT $ <br />I <br />TOTAL FEE $ <br />' <br />TOTALFEE $ <br />' <br />FOR OFFICE USE ONLY: qrrmmwl� <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEF <br />RECEIPT NO <br />LSV/ <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />I ' <br />I IYES 11 NO <br />_ <br />BUILDING <br />O I, <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SRE OF BLDGB.I <br />UNITS <br />PLUMBING <br />T— <br />OCCUPANCY <br />NO OF SI0RIE5 <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />GROUP <br />IIVES !l NO <br />ADDITIONAL PLAN CHECK <br />� <br />I <br />FIRE ALARM RED D <br />REASON <br />OTHER <br />i <br />FIRE SPRINKI. ER RED <br />REASON <br />I <br />STATE BUILDING SURCHARGE <br />TYPE OF CONST <br />PIANS APPROVED BY <br />CITY OF EVERETT <br />PURI IC WORKS <br />i <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />LATE <br />