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i , . �--� �- <br /> APPLICATI4A FOR CONSTRUC7 rOP1 PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL f7 PLUMBING ❑ SIGN <br /> PROJECT ADDRESS <br /> ONTlEH MAILpDDRESS �� C�ILY � 2��� PHONE � ���� <br /> "Z1LX�.'c�� �ci��\ �\ W <br /> TENANT MAI�AUDRESS CITY ZIP P110NE <br /> ! i r'� �f <br /> J � �� ��.� <br /> ARCHITEC�\E�NER MAILADDRE55 CITY ZIP PMONE <br /> T <br /> GENERALC NTRACTOR MAILAUDRESS CITV ZIP PHONE SiATEUCENSE� <br /> MECHANICAL ONTR�CTOq MAILADDRE55 CITV 21P PHONE STATELICENSE� <br /> PLUMBINO C N ACTOR MAIL ADCRESS CIN ZIP PNONE STATE LICENSE� <br /> CONTRACTPRICEOF ORK <br /> Ma�-c�a\S= 10 OCA�Oo ��� HEATING SYSTEM: ^�GAS ❑ ELECTRIC ❑ <br /> DESCRIBEWOflKAN SOUAREFOOTAGEINVOLVED � CONTACTPERSONANDPHONENO. <br /> \ <br /> I HEREBY C[RTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Pi10PO5E0 USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> (�� (Y� PROVIS�ONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> T(�5,� CC\`I� n� \ v�� � \ WOFK WILL BE COMPLIED WITH WHETHER SPEGFIED HEREIN OR <br /> ie LDESC I TIONOFPROPERTV� owwee OPATfAC11TY000P1E5) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior BLOCK oF AUTHOR�TY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> $'L£ p-�-(�C� 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 /> PARCEL TAX I.D.NUMBER CONTRACTORS LAW 1827 FCW AND 296.200 WAC. <br /> s� -oo�-aa�- no/ (� G <br /> CONSTi1UCT10N LOAN LENOEN.AOORE55.TEIEPNONE NOMBER ����� \]�� e��\� _J���� <br /> 51 R DATE <br /> CITY BUS�NESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF FIXTURE OR ITEM FEE <br /> a- WATER CLOSET(TOILEn � P✓C-AMNDLG UNITS-H.P. � <br /> a-. BATHTUB / ; FOFCED AIR SYSTEMS-B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS-B.T.U. M ' <br /> \ KITCHEN SINK 8 DISP � CLOTHES DRYERS � <br /> � DISHWASHER � VENTILATION FAN � <br /> LAUNDRY TRAY � � RANGE HOOD ; <br /> \ CLOTHES WASHER . � \ WATER HEATER � - <br /> URINAL ' WOOD STOVE ' <br /> � ORINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � GAS FIREPLACE � <br /> SINK(SEFVICE-BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING ' <br /> i EXHAUST FAN i <br /> !1 � � <br /> � J✓ ; � <br /> � � <br /> SUB TOTAL ; � � SUB TOTAL $ ' <br /> � <br /> PERMIT 5 � PERMIT S � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE US[ ONLY: <br /> FRONTSETBRCN REARSETBACK S�OESETBRC PUNCHE N A� PEE RECF.IPTNO <br /> 70 ' p ' S� �I �C^. �S //3 �9�% <br /> USEZONE LOTAREA VACANTSITE FE VALUATION FEE 1 <br /> I � ?C ❑YES pUILUING � <br /> HEIGHTLIMITATION NO.OFDWEILING SIZEOFBIIX'i?.I. � <br /> � UNITS PLUM9ING � <br /> OCCUPANCV NO.OF510RIE5 OCCUPANTLOAD BASEMENL MGCIIANICAL ' j <br /> GROl1P <br /> f]YES O NO i <br /> FODITIONAL PLAN CHECN i <br /> � FIREAIAflMREO'0 REASON � <br /> OTIIER � <br /> i <br /> FIRE SPRINKIER REO'D REASON � <br /> SiATE�UILUING SUPCHMGE � <br /> TYPEOFCONST. PLANSAPPROVEDBY CITYOFEVEREIT PUBLICWORKS j <br /> LOCALSALES � <br /> DATE TAX CODE IS 3105 TOTAL � <br />