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APPLICATII.N FOR CONSTRUCT rON PERMIT <br />,,//�� CITY OF ERETT • BUILDING DIVISION . <br />1:�✓yw / (/ p 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />n DEMOLITION f I COMBINATION -BUILDING I14-MECHANICAL IC -PLUMBING f 1 SIGN <br />PROJECT ADDR1,7S// 7I® <br />OWNER 'JAIL A![TRESS (� CITY ZIP PHONE <br />Egy14- a-h0L k :47/7- 3c-� c---v �/41'1/Z, - wauii '�oy.29.2 436.9 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT CR DESIGNER MAIL ADDRESS CITY ZIP <br />GENERAL CVNTRACTOn MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />Sc•-r ut ne ce'6 —'y fop%Rif Sc- O SS- rl <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY 71P PHONE STATE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />CONTRACT PnICL OF WORK <br />HEATING SYSTEM: Io�'GAS I I ELECTRIC f I <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />c 17 <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 />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 WVRK FOR WHICH <br />APPLICATION 15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG <br />X ( ' / 1�LGl..a,t r-,- �L <br />SIGNATURE DATE. <br />PROPOSED USE OF BUILDING <br />5. T <br />LEGAL DESCRIPTI F PROPERTY (SVKVN BELOW OR ATTACH TWO COPIES) <br />LOT_ BLOCK of �u� G 1 <br />f\ �E, y,,�OTHER <br />(+'0' <br />S(�(� <br />PARCEL TAXI D NUMBER <br />CONSTRICTION I DAN(ENDER. ADDRESS, TELEPHONE NUMBER <br />CITY BUSINESS LLJENSG NO <br />PLUMBING <br />MECHANICAL _ <br />NO. OF EQUIPMENT FEE <br />O. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />_TYPE <br />AJC—A(HNDLG UNITS —H.P. <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />, <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />' <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />I <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOT!IES WASHER <br />WATER HEATER <br />, <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />I <br />BACKFLOW PREVENTERS <br />/ <br />GAS FIREPLACE <br />; <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />T— <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL S <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />PERMIT $ <br />_ <br />TOTAL FEE $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SFTBACM _ <br />d!/ U <br />PEAR SFTBAC /J <br />Of <br />SIDE SETBACK _ <br />S <br />PIANCHECK NUMBFIR <br />FF`,_//�j/Qj <br />U <br />RECEIPT NO <br />USE 7.)NE <br />101 AnFA <br />/'?t� <br />VACANT SITE <br />f I YES I1 NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING. <br />R� /-` <br />a$ <br />L1/ <br />q�q- <br />117'9 Tf(� <br />__ <br />HEIGHT tIMITAi1O <br />LLL��f/// <br />NO Of OWELLING <br />UNITS <br />SIZE OF BLGG I <br />1 3o F. LW,.34 {- <br />0 5; GA f .- <br />PIUMOING <br />MECHANICAL <br />, <br />--- <br />✓Y <br />/L.IQv <br />it// <br />OCCUPANCY <br />N001�J51CnIts <br />IX:CUPANL LOAD <br />BASEMENTS <br />YE <br />AODI I IONAI PLAN CHECK <br />; <br />' <br />FIRE ALARM RED 0 <br />PFASOIi <br />OTHER <br />f InF SPRINKI F R RED 0 <br />RFASON <br />STAI E BIIII DING SURCHARGE <br />, <br />TYPE OF CONS) <br />PI ANS APPPDfn BY <br />oAra (o <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />Pumlr. wonKs <br />TOTAL <br />, <br />/)i'<�� <br />