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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT •BUILDING DIVISION `CA/ <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />f 1 DEMOLITION 11 COMBINATION I- I BUILDING MECHANICAL PLUMBING I I SIGN <br />PROJECT ADDRESS —\ <br />MAIL ADDRESS` _ CIE I <br />MAIL ADDRESS <br />CITY <br />nr <br />-�� <br />cP;�M <br />CRONE <br />ARCHITECTORDESIGNER <br />MAIIADORESS <br />Cliv <br />ZIP <br />PHONE <br />GENERAL CDNTnACTO{I <br />MAIL pOD0E55 <br />CITY <br />71P <br />PIIONf BTAIE LICENSE. <br />MECHANICAL CONTRACTOR <br />MAII ADDRESS <br />-Tr- \ \ <br />CHY <br />ZIP <br />PHONE STATE. LICENSE . <br />OF WORK <br />ZIP <br />HEATING SYSTE:d: I GAS f I ELECTRIC [I <br />FOOTAGE INVOLVED CONTACT PFRSO D PHONE ND` F, <br />I HEREBY CERTIFY 1HAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT <br />PROPOSED USE OF BUILDING <br />ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT <br />OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME <br />BLOCK of <br />TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />PEROR THE <br />OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR <br />WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONZAORS <br />PARCEL TAK LD. NVMBER <br />LAW 19. 7 RCW AND 296.200 WAC, <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />xSICNAT <br />DATE <br />CITY BUSINE%LICENSC <br />NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. <br />TYPE OF EQUIPMENT <br />- --- <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />' <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />' <br />; <br />A!C—AMNDLGUNITS—H.P. <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />SHOWER <br />_ <br />HEAT PUMP <br />KITCHEN SINK 3 DISP <br />' <br />UNIT HEATERS — B.T.U. M <br />I <br />DISHWASHER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />LAUNDRYTRAV <br />; <br />RANGE H000 <br />I <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />-- �— <br />BACKFLOW PREVENTERS <br />' <br />GAS FIREPLACE <br />I <br />SINK (SERVICE — BAR, ETC.) <br />—�— <br />GAS RANGE <br />GAS PIPING <br />i <br />EXHAUSTFAN <br />I <br />I <br />- <br />I <br />t <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />IE7'Oo <br />ene nrrUnr <br />TOTAL FEE $ <br />........... .. <br />__ <br />TOTAL FEE $ <br />r el v U <br />1'AONT SETBACK <br />SIDE SETBACK <br />PIAN CHECK NIIMAFn FIE <br />LIN <br />�/y <br />RECEIPT NO <br />TNO <br />USE ZONE <br />L <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />AYES II NO <br />HURDING <br />HEIGHT LIMITATION <br />NG <br />SIZE OF RLDG41 <br />PLUMBING <br />' <br />OCCUPANCY NO OT SloRIES <br />GROUP <br />OCCUPANT LOAD <br />BASEMEN( <br />-- <br />MECIIANICAL <br />IIiFS II NO <br />TIRE ALARM RED <br />Rf ASON <br />ADDITIONAL PLAN CHECK <br />i <br />OUTFIT <br />I <br />FIRE $PRINK( FR gF:00 <br />qF ASON <br />STATE BUIIDING SURCHARGE <br />TYPE OF C,ONST <br />rl ANS APPROVED nY <br />----- <br />- i-- <br />CITY OF EVERETT <br />runny. wonKs <br />LOCAL SALES <br />TOTAL <br />_ <br />OAIL TAX CODE IS 3106 <br />I <br />