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APPLICATIL A FOR CONSTRUC1.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />F1 DEMOLITION F COMBINATION f1 BUILDING F MECHANICi'-L V PLUMBING fl SIGN <br />T 'me, <br />PROJECT ADDRESS La <br />r <br />OWNER 'BAIL ADDRESS CITY ZIP PHONE <br />TENANT <br />MAIL f DORLSS <br />un <br />ur <br />-I—— - <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />PLUMBING CONTRACTOR <br />dns .,- <br />MAILADDRESS <br />/ , _l r— <br />CITY <br />9AA,si "*,q l <br />ZIP <br />iJs/o ..9 <br />PHONE <br />4'lj'1n" 20n.72rir5 <br />STATE LICENSE <br />5ev'/n452y 12,jy <br />CONTRACT PRICE OF WORK <br />9 <br />HEATING SYSTEM: n GAS n ELECTRIC Fl <br />DESCRIBE WORK AND SOU FOOTGE INVOED <br />CONTACT PERSON AND PHONE NO. <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 ORDINAKirES COVERNINii I HIS TYPE OF <br />PROPOSESISF OF LOINc <br />WORK WILL BL COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGALDESCRIPTI NOF PROPERT/(S, -OWN BELOW OR ATTACH T:':O COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK ___ oF__ <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH" <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />' <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 WAG. <br />PARCEL TAX I.D. NUMBER <br />(any/�///❑ //} <br />TM^J <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />X <br />SI NATU GATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />YPE OF EOUIFMENT <br />HO. <br />Tl'PE OF FIXTURE OR ITEM <br />FEE <br />_ <br />CLOSET(TOILET) <br />'DLG <br />IIINITS—H.P. <br />SYS'iEMS — B.T.U. M E.A.LAVATORY <br />EFEEWATER <br />BATHTUBR <br />(WASH BASIN) <br />I <br />WA/0— <br />SHOWER <br />'ERS—B.T.U. <br />MKITCHEN <br />SINK 8 DIS? <br />iRYERS <br />DISHWASHER <br />'N <br />FAN <br />LAUNnRY TRAY <br />; <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />' <br />-- <br />—' <br />URINAL <br />WOOD STOVE <br />_ <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />I <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR. ETC.) <br />GAS RANGE <br />— <br />GAS PIPING <br />EXHAUSTFAN <br />' <br />i <br />T <br />SUBTOTAL <br />$ <br />; <br />SUBTOTAL $ <br />; <br />PERMIT <br />$ <br />I <br />_ PERMIT $ <br />' <br />DOTAL FEE <br />$ <br />TOTALFEE $ <br />' — <br />FOR 01-Hut Lut UTYI_T: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />RECEIPT NO. <br />FEES <br />VALUATION <br />FEE <br />usE ZON[ <br />LOT AREA <br />VACANT SITE <br />AYES i NO <br />BUILDING <br />1SIGIII LIMITATION <br />N0. OF DWELLING <br />SIZE OF BLDGR.I. <br />UNITS <br />PLUMBING <br />T <br />MECHANICAL <br />i <br />' <br />OCCUPANCY <br />110 OF 110RIES <br />OCCUPANT LOAD <br />BASEMENT <br />GROUP <br />1 <br />AYES F1 NO <br />— <br />ADDITIONAL PLAN CHECK <br />' <br />FIRE ALARM REGD <br />REASON <br />i <br />OTHER <br />STATE BUILDING Sill-.:IIARGE <br />' <br />i <br />I <br />FIRESPRINKLERREO'0 <br />REASON <br />PUBI IC WORKS <br />I <br />TYPE OF f.ONST <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />I <br />TAX CODE IS 3105 <br />1 TOTAL <br />�_— <br />DATE <br />