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IO�x <br />ayW <br />v H -V <br />N H <br />Oi <br />08 <br />1. <br />r HZ <br />8 to <br />H <br />Cl U CA <br />p r+1 <br />z CA <br />Ia 0CCA <br />k ( I <br />APPLICATIOkv FOR CONSTRUCTkiN PERMIT v%erelt <br />TO BE COMPLETED IN INK —PLEASE PRINT A <br />CITY OF <br />everett E <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />FANNER MAIL ADDRESS <br />Af lie IF, <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC J <br />BUILDING MECHANICAL <br />CITY ZIP PHONE <br />PLUMBING SIGN <br />-�?S'p- -? a 7/ <br />T NANT v <br />MAIL ADDRESS <br />CITY <br />ZIP <br />:IKmL <br />ARCHITECT OR DESIGNEP <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSER <br />Co 1717 <br />23V4L,�Ll� <br />n T7�e, <br />G <br />aI%S %BdSeZ P/G <br />CN121'joi)11Z <br />MECHANICAL CONTRACTOR <br />. L <br />M DURESS <br />CITY <br />ZIP <br />PHONE <br />I <br />LICENSE A <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />CLASS OF WORK <br />YLov�elo <br />ncALnl mnN <br />WnnnSTOVF/FRPL INSERT <br />BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />O�Xno� rN S�eei o� <br />SED USE OF BUILPING <br />PROPOSED <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />iz <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />OR ATTACH FOUR COPIES) <br />LEG IPtION OF PROPERTY ISHOWN BELOW <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT_ BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRICTION 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 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR AU�TTH.O,R�I,:E(J!�'AGENT DATE <br />C'k <br />X <br />TZin <br />'�i <br />PROJECT ADDRESS <br />Q]� <br />APPIIC NTS CITY BUSINESS LICENSE NO LIDS NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <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 />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />' <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />no Fl C[9n17 "CC nml V• <br />FRONT SETBACK`v <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />PELEIPi NO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />- <br />TYPE OF CONTS ALLOWABLE <br />TYPE OF COAST. ACTUAL <br />acolmAAd <br />WOFORTUn WT15 <br />GRp1° <br />I <br />PLUMBING <br />MECHANICAL <br />SIZE OF SLOG <br />No. OF STORIES <br />BASEMENT <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD <br />FIRE SPRINKLERS REOD <br />HEIGHT LIMITATION <br />I <br />OTHER <br />--T <br />REASON FOR SPRINKLERS <br />� <br />I <br />I <br />STATE BUILDING SURCHARGE <br />PURL IC WORKS <br />i <br />INTAKE BY PLANS APPROVED BY CITY OF EVERETT <br />LOCAL SALES <br />TOTAL <br />TAX CODE IS 3105 <br />I f� <br />_I <br />