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APPLICATIOA FOR CONSTRUCTrON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />f� DEMOLITION f I COMBINATION I] BUILDING MECHANICAL 1 PLUMBING I I SIGN <br />PROJECT ADDRESS it /L `� , / /� gy� <br />OWN MAIL DRESS CITY Y Dr PH0919 <br />G <br />PLUMBING CONTRACTOR MAIL ACIDNESS n n^ _CITY ZIP PHONE STATE LICENSE• <br />CONTRACT PRICE OF WORK <br />Ze; 6, <br />HEATING SYSTEM: GAS l-1 ELECTRIC (l <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />/ <br />O <br />wi <br />fC'2 t <br />1 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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PER THE WORK FOR WHICH <br />APPLICATION IS �v1AIIE CO LY WITH THE STATE <br />CONTRACTORSA'11W 1 D296 OO WAC. <br />/ <br />X <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LC- BLOCK OE <br />PARCEL TAxto. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />SIGNATUR DATE <br />CITY BUSINESS LICENSE 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 —AfHNDLG UNITS —H.P. <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />I <br />NEAT PUMP <br />' <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />_ <br />URINAL <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />_ <br />J <br />^AS PIPING <br />T— <br />EXHAUST FAN <br />' <br />I <br />I <br />- <br />I <br />SUB TOTAL <br />S <br />SUB TOTAL $ <br />PERMIT <br />5 <br />PERMIT b <br />J ' <br />TOTALFEE <br />$ <br />' <br />TOTALFEE S <br />' <br />Onm nCCLPC LLCC CINL Y• <br />FRONT SFTRACK <br />REM SETBACK <br />SIDE SETBACK <br />PI AN CHECK NUMBER <br />ffF <br />RECFIPTNO <br />�� <br />ISE ZONE <br />IOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />OUILDINC <br />I <br />I IYES 11 NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />S1ZE OF BLDG,. I <br />' <br />IINIiS <br />PLUMBING <br />a <br />MECHANICAL <br />' <br />OCCUPANCY NO OF STORIES <br />OCCUPANT LOAD BASEMENT <br />GROUP <br />' <br />[EYES ft NO <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM REO0 <br />PEASON <br />T <br />OTHER <br />i <br />FIRE. SPRINKLER RFOO <br />RF/.AON <br />' <br />57ATE BUILDING SURCHARGE <br />1 <br />PIIPLIf, WORKS <br />TYPE OF CONST <br />PLANS APPROVED BY <br />CITY OF EVERETT ERETT <br />LOCAL SALES <br />; <br />TAX CODE IS 3105 <br />TOTAL <br />' <br />DATE <br />