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PT <br />,-. <br />APPLICATI�iA FOR CONSTRUCTrON PERMIT <br />� E���� everett <br />���oF e <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br />XXDEMOLITION i� COMBINATION J BUILDING MECHANICAL 1PLUMBING L7 SIGN <br />ON?!EH MAILADDRE55 CITV ZIP PHONE <br />GORDON 6.CARDLCBJORG 954 No. Park Everett 98203 252-2300 <br />TENANT MAIL ADDRE55 CITV ZIP PHONE <br />Everett Fire Dept. ,2811 Oakes Everett Wa 96201 259-8705 <br />ARCHITECTORDESIGNER MAILADDRE55 CITY 21P PMONE <br />GENERAL <br />1�P PHONE LICENSE t <br />cm <br />GIiY ZIP PHONE LICENSEI <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION I � ALTERATIOY i. i REPAIR ' DEMOLITION C' WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br />TENANT IMPROVcMENT OR INTEPIOq REMODEL ONLY I CONTqCT PERSON AND PHONE N0. <br />CONTqACT PRICE OF WORK: <br />Demolition 5,000 sq. ft. <br />PROPOSEU USE OF BUILUING <br />�or N4S*Z� BLocK OOOD—OpF TR 4g <br />� <br />4W FOR 178.28FT FROM MOST ELY <br />WATER CLOSET (TO�'. <br />BATHTUB <br />LAVATORY (WASH BA; <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTH'cS WASHER <br />DRINKING <br />FLOOR DF <br />SINK <br />FRJNTSETBACK <br />USE ZONE <br />TYPE OF �ONSi. ALLOWABLE <br />SREOFBLDG. <br />OCCUPANCYLOAD <br />REASCN FOR SPRINKLERS <br />qPPLICRTION ACC. BV <br />PREVENTERS <br />OR ITEM <br />SUB TOTAL <br />PERM�T <br />REAqSETBACK <br />lOi AREA <br />TYPE OF CONSi. ACiUAL <br />NO.OF STORIES <br />FIRE SPRNKLERS REO'D <br />YES i NO <br />PLANSAPPPOVEDBY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME 70 BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <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 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AU7HOFIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION �S MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIGNqTURE OF CONTRACTOR OR AUTHORIZED AGENT DAiE <br />X ,�� ��1� -✓ � <br />�fe� ( Er.�.r n F.re ��i� <br />MPLICANTS CITV BUSME3SE C SE NO. AND BUSINESf NAME �r— <br />FEE N0. TYPE OF EUUIPMEN' <br />� !VC—NHNOLG UNITS—H.P, <br />; FORCED Alq SYSTEMS—B.T.U. <br />i UNIT HEATERS—B.T.U. M <br />' CLOTHES DRYERS <br />� VENTILATION Fl.N <br />� RANGEHOOD <br />; WATER HEATER <br />� WOOD STOVE <br />' METAL FIfiEPLACE 8 CHIMNEV <br />� FIREPLACE INSERT <br />' HEAT PUMP <br />� GAS PIPING <br />! EXHAUST FAN <br />SI E SETBACN <br />VACANT SITE <br />❑ YES I '. NO <br />OCLU>I.MLY NO Of bJlElliN6l <br />LNOIIP <br />9ASEMENT <br />: . YFS ��I NO <br />NEIGHT LIMITAiION <br />CITY OF EUERETT <br />LOCALSALES <br />TAIf CODE IS 3105 <br />PLANCHECKNUMPER <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OtHER <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />SUB <br />� <br />RECEIPT NO. <br />FEE <br />