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APPLICATIO.� FOR �ONSTRUCT�JN PERMIT <br /> CITY OF EVERETT•BUILUING DIVISION <br /> 3200 CEDAR STREET• EVEREIT, WA 98201 •259•8810 <br /> � DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUM011dG ❑ SIGN <br /> PROJECT ADDRESS: /2 3 � �0��,.���1�) <br /> GNTlER MAIL�UDRESS Cltt IIP pHONE <br /> JW C/-75W lNT ��o G21/r�U qv- rvr�rh� y,Pzl7/ zS�-893� <br /> TENANT IAAL oOnF55 LILY i1V {`iIONE <br /> �RCHITECTOHDESIGKlO M�It�DDRE55 CITY 71P nNONE <br /> f•ENEMLCONTMCTIXi MAILAOORE55 CIIY IiP pIION[ SIAtE��g[NSE� <br /> MECNANICAICONTRACIOR M�qpODRE55 CITV ZIP p��ONE STATEULENSE� <br /> PlUM81NGCONiRA�TOP MRILAODRESS CITV IIP PHONE STRIEUGENSE� <br /> CONTqACT VRICE OF WORR —� <br /> N='ATING SYS7EM: ❑ GAS ❑ ELECTRIC ❑ <br /> DESCRIOE WORK AND SOUARE FOOTAGE INVOLVED GO!�I�CT CERSON�ND PNONE ND <br /> .� <br /> � <br /> I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED THIS <br /> PROPOSEDUSE O:BUILDING APPLICATION AND KNOW TH[ SAME TO BE TFiUE AND CORRECT qLL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALOESCRIPiIONOFPROPERtt�SHOWNBELOWOqAiT�LMTWOCOPIES) NO'. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> toi e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PEHFOFMANCE OF CONSTRUCTION.THAT I AM AUTHOHRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX I.O.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSiRUCiION LOAN LENDER,AOURE55.TEIEPlIONE NVMBER X� ��� f 1=-� <br /> SI ATURE O�TE <br /> CITY OIISINESS LICENSE NO <br /> - PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—MiNDLG UNfTS � <br /> BATHTUB ; FORCEDAIRSYSTEMS � <br /> LAVATORY(WASH BASIN) i HEAT PUMP , <br /> SHOWER � UNITHEATEFS � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> DISHWASHER � RANGEHOOD � <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL � METAL FIREPLACE(VJOUG BURNING) � <br /> DRINKING FOUNYAIN ; FIREPLACE�NSERT(WOOD BURNING) ' <br /> FLOOR URAItv � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS RANGE ; <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> EXHAUSTFAN <br /> � — <br /> � <br /> —•— <br /> i , <br /> SUB TOTAL S ; SUB TOTAL E ' <br /> PERMIT $ , pEAMIT $ � <br /> TOTALFEE $ � TOTAIFEE 5 � <br /> FOR OFFICF. USE ONLY: <br /> FROHT SETB�CN PEAR SETBACK SIDE SETB�CN �LAN CIIECN N11MOE11 FEF �ECEIPi NO <br /> t) �<.)-`�) <br /> USEZONE IOiAREA VACANiS�TE FEES VALUA'PION FEE <br /> ❑YES ❑ NO OUILDING � <br /> � <br /> i <br /> HEIGHT LIMITATION 40 OF UWELLING SIZE OF BIDG�f.I � <br /> UNIiS <br /> PlUlAOING <br /> OCCUPANCY NO Oi SIONES OCCUP�Ni IO�D 9�SEMENT MECIInNICAL I <br /> GFOUP <br /> ❑YES ❑NO <br /> FIRESPRINKIEflREOD BEFSON nO�IIIONPLPUNC�IF.CN <br /> —T-- <br /> OiHE11 � <br /> FIREALAFlMPEO'D REASON — <br /> SinTE OUqDWC SIIRCIURCE <br /> TYPE nF f,ON57 PLANS�PPROVED BY <br /> CITY OF EVERE7'T �IlBllf.WOPKS <br /> LOCAL SALES —�-- <br /> o�Tz TAX CODE IS 3105 TOTAL <br />