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C:j <br />1 h_� <br />APPLICATIOd FOR CONSTRUCTION PERMIT <br />Nx EVnrg.Pen TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett FHEATING SYSTEM: GAS ❑ ELECT IC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION Ci BUILDING ECHANICAL PLUMBING SIGN <br />pyILADDPC CITY 21P PHONE ,-7-s 9-5�-r7 <br />�l^/ e �� ,! �lt 9�:n1 7SR_ 'c✓1 /ram._,, 2_ Sri <br />TENANT <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />MECHANICAL CONTRACT <br />MAIL AD S` <br />CITY <br />IP <br />PHONEIIIICENSE• <br />�^ ^ q <br />PLU RING CONTRACTOR <br />MAIC AD' RESS <br />ITV <br />ZIP <br />PHONE <br />LICENSE I <br />CLASS OF WORK <br />- <br />f n oeoAle <br />n nGfdnl ITInN <br />" - WnnnRTOVE/FRPL INSERT <br />_ <br />_. BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />\ Q Gr <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SDyAPE FOOTAGE INVOLVED <br />�Lr- <br />rr <br />8� -�f� � <br />crnxi;x��.✓e�ebv-�ir�c.�cr�Lw�tids;�„ �^.,uu-,: � <br />_ <br />PRO°OSED USE OF BUILDING <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOi BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VICLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR Lf'CAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 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 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR CR AUTHORIZED AGENT DATE <br />PROJECT ADDRF.S <br />/. -7 <br />APPLICANTS CItt BUSIN[SS LICENSE NO AND BUSINESS NAME <br />L- '� I O�li lC•. rt'i ��• (. iL <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A'HNDLG UNITS—H.P. <br />BATHTUB <br />j <br />FORCED AIR SYSTEMS M E.A. <br />(WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. <br />_LAVATORY <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />' <br />! <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />J-1RACKFLOW <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERTFLOOR <br />DRAINAT <br />PUMP <br />PREVENTERS <br />i <br />GAS PIPING �- <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />i <br />T <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />J ' <br />PERMIT S <br />PERMIT $ <br />/S <br />TOTAL FEE $ <br />' <br />TOTAL FEE <br />rnn nerinr I ICC nWl V. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />3(0/30 <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— _ - <br />PLUMBING <br />TYPE Of CONTS. ALLOWABLE <br />TYPE Of CONST ACTUAL <br />GRWF <br />SIZE OF BLDG. <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE SPRNKLERS REDD <br />HEIGHT LIMITATION <br />OTHER <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />___ <br />INTAKE Dv <br />PLANSAPPROVEDBY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBUCWORKS <br />TOTAL <br />