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APPLICATIVrd FOR CONSTRUC7.ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />11 DEMOLITION f 1 COMBINATION ("I BUILDING I 1 MECHANICAL PLUMBING I I SIGN <br />PROJECT ADDRESS <br />OWNe111 rMAIL ADDRESS CITY PIP PHONE <br />jIlt►� i�eti�l/L7��5 II 1a 7 sA- YKA-7f)(z t <br />TlIIBWr MAIL ADDRFSS <br />CITY <br />]IP <br />PHONE _ <br />3S(7 Co �flLC-S <br />��/c �E� <br />C�,71J I <br />ARCNITECTOROESIGNER MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />..'' 11 <br />0W-'I.- e—``v)L <br />GENERAL CONTRACTOR MAILADORESS <br />(R 'Y <br />71p <br />PHONE STATE LICENSE• <br />0W vx-p Lr2 <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY <br />71P <br />PHONE STATE LICENSE <br />PLUMBING CUNIHACTOR MAIL. ADDRESS CITY Zip PHONE STATE LICENSE <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: I I GAS T 1 EL''CTRIC I I <br />DESCRIBE AnE FOOTAGE IN LVEDD , <br />�I <br />1 <br />CONTACT PERSON ANO PIIONF NO Y`; `,, _ <br />tCJ <br />� r L, I Vt <br />L"Ls <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 />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 />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 16.27 RCW AND 296,200 WAC. <br />XX <br />PROPOSED USE G� PIIILDING <br />LEGAL DESCRIPTION OF PPOMEHIIri,�SSH.,O BELOW OR ATTACH T OCOPIEI <br />LOT eLocK�•! of I - E eti.rt'r <br />I <br />y 1 t <br />-7,LtQt '�!'n <br />PARCEL TpA%LD. NUMBER <br />Lk <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />Si*Alk <br />v OATE <br />CI SINF.SSUCENS 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 —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 />r— <br />SHOWER <br />I <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 6 DISP <br />; <br />CLOTHES DRYERS <br />DISHWASHER <br />I <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />; <br />CLOTHES WASHER <br />WATER HEATER <br />WOOD STOVE <br />I <br />URINAL <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />i <br />EXHAUST FAN <br />- <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />I <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />READ SETBACK <br />SIDE SETBACK <br />rI AN CHECK NUMDFR <br />FFF <br />RECEIPT NO <br />// <br />USEZONE� <br />IOTARFA <br />VACANTSHE <br />FEES <br />VALUATION <br />FEE <br />/ <br />T �%b <br />AYES Y(1 <br />—� <br />BUILDING <br />1-7 20 <br />HEIGH, LIMITATION I <br />NO OF DWELLING <br />SIZE OF BLOGnI <br />IINIIS '^ <br />qA /}ice„ <br />PLUMBING <br />OCCUPANCY <br />NO 01110WES <br />OCCUPANT LOAD BASEMENT <br />MECHANICAL <br />GROUP <br />AODIIIONAI. PI AN CHECK <br />i <br />I IYFSIY[5 'ENO <br />RED <br />FIRE ALARM REDO <br />REASON <br />OTHER <br />FIRE SPRINKI F D REDO <br />REASON <br />I <br />STATE BUILDING SUnCHARGE <br />(' <br />I Sv <br />TYPE OF coesT <br />Pt nNs nrrnovpn BY <br />CITY OF EVERETT <br />runt IC WORKS <br />J 14 <br />LOCAL SALES <br />TOTAL <br />I <br />-/J <br />DAIL 8 /d 4f <br />TAX CODE IS 3105 <br />