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APPLICATI(od FOR CONSTRUCT SON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 4wff <br />1_� DEMOLITION f1 COMBINATION I BUILDING II MFCMeNIrAI <br />PROJECT ADDRESS/'y ) <br />OWNER MAILADDRESS CITY <br />ZIP m,nur <br />Sc�1L�c <br />TENANT <br />48�c� - <br />6.ra /3oQ_— <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAII ADDRESS <br />CITY <br />ZIP <br />PHONE. <br />GENERAL CON ACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />fltt <br />IIP <br />PHONE <br />STATE LICENSE• <br />PLUMBING CONTRAP,TOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />CONTgAC PRICE OF WORK <br />HEATING SYSTEM: I I GAS I ELECTRIC ' I <br />DESCRIBE WORK AND SQUARE FOOTAGEINVOLVED <br />CONT CT PFRSON AN 11111NO <br />Fc p <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROPOSED USE OF BUILDjNG <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />LtbAL OESC PTION OF PROPERTY HOWN BELOW Oq A1TAC!/TWO COPIESI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT - ;� BLOCK OF It I <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 />CONTRACTORS LAW 6.27 RCW AND 296.200 WAC. <br />PARCEL TAX I.D. NUMBER �J�j / <br />c1 (r <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />X <br />?IGNATUR 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 />.A/C—AMNDLGUNR-S—H.P. <br />BATHTUB <br />( <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />, <br />HEAT PUMP <br />—�— <br />SHOWER <br />' <br />UNIT HEATERS —B.T.U. M <br />KITCHEN SINK 6 DISP <br />J <br />CLOTHES DRYERS <br />VENTILATION FAN <br />DISHWASHER <br />I <br />LAUNDRY TRAY <br />f <br />RANGE HOOD <br />' <br />CLOTHES WASHER <br />WATER HEATER <br />�— <br />URINAL <br />WOOD STOVE <br />I <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOC BUFiNING) <br />i <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />�— <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />' <br />SINK (SERVICE — BAR. ETC.) <br />GAS RANGE <br />_ <br />GAS PIPING <br />EXHAUST FAN <br />_ <br />SUB TOTAL S <br />SUB TOTAL $ <br />PERMIT $ <br />, <br />PERMIT $ <br />TOTAL FEE $ I <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />c2U <br />REAR SETBACK <br />r%iJ <br />SIDE SETBACK <br />lZ J <br />PIAN CHECK N/�ILIBr <br />r•�cl �l%o� <br />IEr <br />�V <br />RECEIPT NO <br />USEZONE <br />_ J-- <br />.: ' � <br />IOTAREA <br />VACANT SITE <br />YES I ; No <br />_FEES <br />D111101NG <br />VALUATION <br />FEE <br />' <br />HEIGHT LIMITATPN <br />Jd <br />110 OF OWLLLING <br />uNITS <br />/ <br />SIZP OF BL I <br />I'73� CIv1..Aca + <br />S,F. G44A6E <br />PLUMBING <br />OCCUPANCY <br />GROII <br />I NO O1110,1115 <br />OCCUPANT LOAD BASEMENT+— <br />MECHANICAL <br />W� ; <br />AOUI I IONAI. PLAN CHECK <br />FIRE ALARM RED R <br />REASON <br />O1HER <br />FIRE SPRINKI B R PTOD <br />BEACON <br />STATE BUILDING SURCHARGE <br />TYPE OF C.ONS7 <br />t.- <br />JL -/.1 <br />PI ANS APPROVED BY <br />'i A- <br />DATE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PHRHC WORKS <br />20C1= <br />TOTAL <br />- <br />; <br />