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YNIs Ns <br />I ®' <br />® AYNI� <br />APPLICATIUN FOR CONSTRUCT ION PERMIT <br />the EYOF9reon TO BE COMPLETED IN INK —PLEASE PRINT <br />C"TY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION ! 1 COMBINATION <br />HEATING SYSTEM: ❑ GAS VfELECTRIC ❑ <br />j BUILDING <br />PLUMBING <br />everett <br />SIGN <br />TENANT / <br />l <br />Nwc wuncao <br />/ o <br />S� E 2 <br />/ <br />ARCHITE TOR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE LICENSE# <br />�wr <br />O,a��is T'es <br />�F�cdTs� <br />MECM ))CAL CON TRACTOR <br />MAIL ADDRESS <br />CITY <br />DP <br />PHONE LICENSER T <br />�5=3z.� l��o�PQ� <br />�1iaTlevns <br />�o �e,l <br />/alp L�n„� oa Gin <br />9�la/sC <br />Pi I iunlNr, rnNTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONELICENSE <br />CLASSOFWO.?K <br />r 1 eceelo FICMAEII ITNTN r WOOOS7OVE/FRPL INSERT _, BUILDING RELOCATION <br />CONTACT PERSON AND PHONE._ <br />G <br />CONTRACT PRICE OF WORK �� <br />DESCRIBE WORK AND SOUARE FOOTAG MVOLVED <br />" <br />Rs <br />PROPCkaOB DUSEOFBUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />�n <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN HELOWOR ATTACH FOUR COPIES)) <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 1 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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />[VC 6.7 `3 YV <br />PROJECTADDR�$$� <br />ff <br />APPLICANTS CITY BUSINESS LICENSE NO. AND BUSINESS NAME <br />MECHANICAL <br />PLUMBING 43 <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />/ <br />A/C—A/HNOLG UNITS—H.P. -it, <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />i <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />I _ <br />URINAL <br />' <br />METAL FIREPLACES CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR. ETC.) <br />I <br />' <br />T <br />I <br />' <br />� <br />1 <br />SUBTOTAL $ <br />SUBTOTAL $ <br />-20 Iyo <br />PERMIT $ <br />1 <br />PERMIT $ <br />J <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />.S ' <br />FRONT SETBACK <br />vREAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />I <br />TYPE OF CONTS.ALLOWMBLE <br />TYPE OF CONST. ACTUIL <br />D6WMNCY <br />NO a DMWNGUNns <br />GRWP <br />PLUMBING <br />SIZE OF BLDG. <br />NO.Oi STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCYLOAD FIRE SPHNKLERS REOD HEIGHT LIMITATION <br />I <br />OTHER <br />—r— <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />� <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />— <br />LOCAL SALES <br />TOTAL <br />I <br />Llr 610 <br />�GeY <br />TAX CODE IS 31115 <br />