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APPLICATII,Nd FOR CONSTRUCT NON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />Fl DEMOLITION Fl COMBINATION X BUILDING n MECHANICAL PLUMBING <br />PROJECT ADDRESS <br />30 ) m1+17) soAl C.K �JA <br />OWNER MAILADDRESS CITY ZIP PHONE <br />1-1 SIGN <br />_RN <br />Smif <br />�r�) <br />aplsn l/ <br />l �N <br />_ <br />MAIL DORE55 � <br />CITY <br />ZIP <br />PHONE <br />SSG <br />99zo----,-3 <br />ass <br />sSio <br />ARCHITECT OR DESIGNER <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE ' <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />l�LK % <br />MECHANICAL ONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE x <br />rnv,✓,rk <br />PLUMBING CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE It <br />l.vrvI nnbI rnlGt ur.7 ^/J <br />v//(/ HEATING SYSTEM: F1 GAS AELECTRIC <br />DESCRIBE WORK AND SOUARE FOO GE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />1 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 />CONTRACT IRS LAW 18.27 RCW A D 296.200 WA . <br />X <br />PROPOSED USE OF BUILDING <br />RI77��T � AZ r l21 <br />PROPE(SHOWN OR ATTACH COPIES) <br />LEGAL OESCRIPTI NOF PROPERTY <br />LOT' BLOCK OF <br />PARCEL TAX I.D. MBER <br />O&dd os3 oar 6 oa S <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />SIGN T 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 />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />'r <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 />i <br />CLOTHES DRYERS <br />i <br />DISHWASHER <br />VENTILATION FAN <br />' <br />LAUNDRYTRAY <br />RANGE HOOD <br />i <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE - BAR, ETC.) <br />I <br />GAS RANGE <br />' <br />GAS PIPING <br />' <br />EXHAUSTFAN <br />I <br />' <br />I <br />I <br />' <br />' <br />I <br />' <br />SUBTOTAL $ <br />1 <br />I <br />� <br />SUBTOTAL $ <br />J <br />PERMIT $ <br />I <br />PERMIT $ <br />I <br />TOTAL FEE S <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETB/; { <br />REAR SETBACK <br />SIDE TBACK � <br />PLAN CHECK N MBFF <br />FEE /J <br />RECEIPT NO. <br />USEZONE yx <br />LOTAREA <br />VACANT SIT <br />f1VE5 fl NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />Z� <br />i- <br />_ <br />HEIGHT LIMITATION / <br />NO OF DWELLING <br />UNITS <br />SIZE OF BLDGITI <br />A? <br />PLUMBING <br />' <br />OCCUPANCY NO ''ONES <br />GROUP <br />OCCUPANT LOAD BASEMENT <br />w 11A f1 YES 1 0 <br />Ill <br />MECHANICAL <br />' <br />' <br />- <br />FIRE ALARM REO'D <br />yy <br />REASON <br />ADDITIONAL PLAN CHECK <br />I <br />OTHER <br />i <br />FIRE SPRINKLER RED <br />REASON <br />' <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />✓ <br />TYPE OF CONST <br />PLANS APPROYVEP BY <br />CITY OF EVERETT <br />`� <br />DATE 4 <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />i/ I �� <br />G <br />