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APPLICATIQ ' FOR CONSTRUCT' <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />)N PERMIT � <br />HEATING SYSTEM: I,] GAS ❑ ELECTRIC ❑ N. A. _ 1 <br />BUILOING DEPARTMENT <br />25Fi-8810 <br />❑ DEMOLITION ❑ COMBINATION i�Q BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />pyyry,±q MAILPODRE55 CITV 21P PHO4E <br />Housing Authority of the City of Everett, 1401 Poplar, Everett, WA 98201 258-9222 <br />TENANT MAIL RDDRE55 CI7Y 21P PNONE <br />Saine <br />RRCHITECTORDESIGNER MAILAODHE55 C11Y 21P PMONE <br />CNJJ Architects, 2722 Colby, Suite #607, Everett, WA 98201 259-1560 601-291-562 0 <br />GENERAL GONTRACTOR MAIL FDDRESS CITV ZIP PMONE STRTE LICENSE t <br />MECH�NICAL CONTRRCTOR MML ADORE55 CITY 21P PHONE STATE LICENSE II <br />VWMBING CONTRACTOR MAIL RODRESS CITY ZIP PHONE SiATE LICcNSE � <br />CONTRACT PRICE OF WOPK <br />DE IBE RKANDSWAREfI <br />�`I�sce�laneous �i <br />s. . and extei <br />exi�tipg�dr <br />accessibility. <br />PROPOSED USE OF BUILDING <br />Low-Ineome Hrn <br />LE Wl DESCRIPTION OF PROPER <br />LOT BLOCN - <br />(See Attached) <br />PARCELTRXID.NOMBER <br />CONSTRUGTIdJLOANLENDER./ <br />PROJECTADDRESS <br />630/832 Pine <br />PLUMBING <br />Np, TYPE OF <br />WATERCLOSET <br />BATHTUB <br />LAVATORY(WA; <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />�.Al1N�RY TRAY <br />LONTRC7 PERSON AND PNONE NO <br />�r (plus or minus <br />alterations in two <br />CNJJ <br />560 <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 ORDINANCES GOVERNING THIS TYPE OF <br />LOWOPATfACHTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />�F AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORRED BV 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 7827 RCW AND 296200 WAC. <br />TELEPHONE NUMBER <br />Fl7CTURE OR <br />FOUNTAIN <br />FLOOR DRA <br />BACKFLOW <br />SINK <br />FOR OFFICE USE ONLY: <br />FRONTSETBpCN REAR: <br />USE20NE <br />1YPE CON57. / <br />N <br />SIZG OF BLDG. <br />�(� i�yy Sq.Kt <br />OCCUPANCYLO�D <br />FEE <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTALFEE 5 <br />lOT AREA <br />NO. OF STORIES <br />/ <br />FIRE SPRINNLERS REO'D <br />,t1J <br />FIRE ALARM REOD <br />SIDE SETBACK <br />❑ YES ` ; NO <br />OCCUVANp M1DO�PMIUMGUNi'i <br />BASEMENT <br />❑ YES �. 0 <br />NEIGHT UMITATION <br />INTAKE BY PLAN APPROVED BV CITY OF EVEflETT <br />�A LOCAL SALES <br />oqTE •� _ �S _ S? TAX CODE IS 3105 <br />MECHANICAL <br />i0. TYPE OF EOUIPM <br />N�NHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B: <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE� <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUSTFAN <br />CHECK NIIMBER <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCF',�RGE <br />PUBLIC WORKS <br />TOTAL <br />M E.A. <br />0 <br />SUB TOTAL S <br />PERMIT $ <br />TOTALFEE $ ' <br />REGEIPT NO. <br />VALUATION FEE <br />/ � � �.� <br />1 <br />- 'T <br />1 <br />� <br />i�l <br />L � j l <br />i <br />i <br />� <br />� <br />�� <br />