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APPLICATIO"d FOR CONSTRUCTON PERMIT <br />me r. ,, TO 6E COMPLETED IN INK —PLEASE PRINT <br />CITY OP <br />everett <br />BUILDING ♦ gjt�ENT <br />259-8810% i!! �� 5 <br />DEMOLITION C7 COMBINATION <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />everett <br />e <br />C BUILDING ❑ MECHANICAL ❑ PLUMBING `-i-MGN <br />• <br />W,{{1L'{LA�` ESr'1'1����LLLE1 <br />I Ijjjv���-��^V ZI�'�M./ ,Y•V <br />PNONE <br />W 1C <br />MUS <br />D ({�Io <br />21P <br />Ty h/A <br />PHONE <br />ILR/y/j <br />1 NE <br />A <br />1�jDQ <br />iON <br />"AtCCMMACTOR <br />AO RESS <br />IADDRESB <br />%I�I�Y <br />CITY1VVJ_(�. <br />—F�/� <br />IFEAD <br />CAIL <br />'. <br />CITY 21P <br />e <br />PHONE <br />ounuc <br />LICENSES <br />LICENSE <br />PLNNBIRtCTRAUTUH wncw — — <br />CLASSOF WORK <br />✓MCW I- ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION Ci WOODSTOVE/FRPL INSERT G BUILDING RELOCATION <br />- W)W1^/LD' <br />IW!N I UU <br />LONT E 5 NO H A.�' <br />CONTRACT PRICE OF WOR <br />nn pIB,1rF1„W,�O1R/K/ Np V O <br />V°f rQa d l Eli <br />� <br />W ' • V <br />PAQEDSEµLSE_OFBpIv CI yy>, <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />I I 1 <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />L/6Y/V' T7����I�pY/Vl VVVII"`lllU/// <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR Ann HFOUR OPIE51 <br />SP <br />LOT BLOCK OF Ut <br />NOT. THE GRANTING OF A PERMIT DOES NOT <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 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 />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />AGENT DATE <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED <br />xyRIMY�ll�/'I tYlQ4N Pvv l <br />—��� <br />APPLICANTS CITY BUSINESS II ENS N0..Np BUSINESS NAME <br />�yoa sc cA. <br />_ <br />PR T RE <br />O <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />N0. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A/C—AMNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />I <br />I <br />' <br />I <br />SUBTOTAL $ <br />; <br />SUBTOTAL $ <br />PERMIT $ <br />I <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE�0�/ <br />.•pp77 <br />RECEIPT NO. <br />USE ZZ l� <br />LOT AREA <br />VACANT SITE <br />o <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />00 <br />(/ <br />I <br />i <br />TYPE OF CONTS. ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />GRupma <br />GRMP <br />N07 MLLI�� <br />SIZE OF BLDG. NO. OF STORIES BASEMENT <br />OCCUPANCY LOAD FIRE SPRNKLERS REOU HEK+HT LIMITATION <br />REASON FOR SPRINKLERS <br />MECHANICAL <br />1 <br />' <br />ADDITIONAL PLAN CHECK <br />I <br />OTHER <br />I <br />) <br />! <br />STATE BUILDING SURCHARGE <br />I O <br />/ I <br />PUBLIC WORKS <br />I <br />' <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />