6120 FLEMING ST 2016-01-01 MF Import

� I�[ APPLICATI4.� FOR CONSTRUCTrON PERMIT Me Everpreen CITV OF everett BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT 259-8810 DEMOLITION ❑ COMBINATION ❑ BUILDING CJ MECHANICAL I7 PLUMBING I� Ep � �� / L MA��✓��55/"'//J.✓�,.. .� i. �/a llo// � � Z�/ ��G'_J YHONE �7 � J _ �.71 MAIL ADDRE55 21P PHONE c�rv nr rn�ne QENERALCONTRACTOP MAILADDRESS CIiV ZIP PHONE LICENSEN MECHMlIG1LCONTRACTOR MAILRDDRE55 CITY 21P PHONE LICENSEF PLUMBINGCONTR�CTOR MAILAODRESS CIN 21P PHONE LICENSEI everett e ❑ SIGN CUSS OF N'ORK �/ ,, ❑ NEW ❑ ADDITION ❑ ALTERATION G REPAIR jwL+EMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION TENANT IMPflOVEMENT OR INTERIOR REMODEL ONLY � �E(3AL DESCRIPTION OF PHOPt LOT�� BLOCK WATER CI BATHTUB KITCHEN SINK 8 DISHWASHER LAUNORVTRAY CONTACTPERSONANDPHONENO. � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL OWN BELOW OR ATf�CM FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � T � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR oF � r r NOT. THE GRANTING OF A PFRMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS CF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE. — PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH AFPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND 296200 WAC. SIGNATUREOFCONTRACTORORAUTHOflIZEDAGENT DATE � r H� � -Xr/+.��,f�� .�'-;� � yv APPLICANTS CIN BUS ESS LICENSE NO. AND BUSINE55 NAME URINAL DRINKING FOUNTAIN FLOOfl DRAIN ROOF SINK I FRONTSEiBACK USE ZONE TYPE OF CONSL ALLOWPBLE 5¢EOFBLOG. OCCUPMICYLOA� REASON FOR SPRINKLERS APPLICATION ACC. BY FEE TOTAL FEE $ REARSETBACK SIDESETHACN LOTAREA VACANTSITE ❑ YES ❑ NO TVPEOFLONST.ACTUAL aaPANtv Na.ofVHEIUNGi sxauv NO.OF STORIES BASEMENT ❑ YES ❑ NO FIRESPRNKLERSflEO'D HEIGHTLIMITATION ❑ YES ❑ NO PLANS APPROVED BY CITY OF EVERETT LOCALSALES TAX CODE IS 3105 A/C--A/HNDLG UNITS—H.P. FORCED AIR SYSTEMS—B.T.U. M E.A. UNIT HEATERS—B.T.U. M CLOTHES DRYERS VENTILATION FAN RANGEHOOD WATER HEATER WOOD STOVE METAL FIREPLACE B CHIMNEY HEAT PUMP GAS PIPING EXHAUST FAN SUBTOTAL $ PERMIT $ TOTAL FEE $ PLANCHECNNUAIBER FEE RECEIPTNO. FEES V.�LUA710N ree i BUILDING � i PLUMBING i i MECHANICAL � � OTHER � i STATE BUILDING SURCHARGE � ---1 STATEENERGVSURCHARGE � i PUBLIC WORKS i TOTAL ;