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APPLICATIOd FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />CI DEMOLITION I I COMBINATION F1 BUILDING yiMECHANICAL I,4PI uWIRINIr n Q11"m <br />CONTRACT PRICE OF WORK pp <br />~d�Q <br />HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />6k, <br />I 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 ORNOT. 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 PLY WITH THE STATE <br />CONTRACTORS L D 6.20O WAC. <br />X <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL. TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS. ELEONE NUMBER <br />SIGNATURE DA <br />CITY BUSINESS LICENSE NO. <br />_PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS - H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />_ <br />LAVATORY (WASH BASIN) <br />i <br />HEAT PUMP <br />SHOWER <br />' <br />UNIT HEATERS - B.T.U. M <br />KITCHEN SINK & DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />' <br />CLOTHES WASHER <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 />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE - BAR, ETC.) <br />GAS RANGE <br />GAS PIPING i <br />EXHAUSTFAN <br />SUBTOTAL $ <br />SUBTOTAL $ <br />; <br />PERMIT S <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ 1' <br />FOR OFFICE USE ONLY: <br />FRONT SET BACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHE ABEjo <br />FEE <br />RECEIPTNO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />El YES ❑ NO <br />BUILDING <br />' <br />HEIGHT UMITATION <br />NO. OF DWELLING <br />SIZE OF BLDGRI. <br />PLUMBING <br />i <br />�— <br />UNITS <br />OCCUPANCY <br />GROUP <br />NO.OFSTONES <br />OCCUPANTLOAD <br />DASEMENT <br />MECHANICAL <br />❑YES FT NO <br />ADDITIONAL PLAN CHECK <br />I <br />�— <br />FIRE ALARM REO'D <br />REASON <br />OTHER <br />i <br />-- <br />FIRE SPRINKLER REOD <br />REASON <br />STATE BUILDING SURCHARGE <br />� <br />TYPE OF CONST. <br />PLANS APPROVED BY <br />OF EVERETT <br />PUBLIC WORKS <br />' <br />CAL SALES <br />FTAX <br />TOTAL <br />DATE <br />CODE IS 3105 <br />