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C 1 <br />s <br />APPLICATIGA Fon CONSTRUC? iON PERMIT <br />E <br />the Emp,een <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK —PLEASE PRINT <br />CI DEMOLITION I I COMBINATION X BUILDING MECHANICAL I I PLUMBING I I SIGN <br />OMEN MAIL ADDRESS CITY ZIP PHONE <br />TENANT MAIL ADDRESS CITY ZIP PHONE ,f <br />bee. Raes Ftsh Maa(,uc_\Lltte,:Q isR l_-uc& d7t WA <br />ARCHITECT On DESIGNER MAIL ADDRESS CITY ZIP PHONE ' <br />ne5,c�o Ascoc 1. c 6630 198 - 5T, S. ), j) a4i, 775- 7J(3 <br />YY.NPHONE <br />GENERAL CONTRACTOR AIL ADDRESS CITY ZIP LICENSEE <br />I <br />J� a rr l���55 5c) �l101/ Avt ASS- 5ti67 BmGlnr_ -IN4J <br />MECHANICALCONTRACIOR MAIL ADDRESS CITV ZIP PHONE LICENSEI <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />CLASS OF WORN <br />I I NEW LI ADDITION X ALTERATION 1_I REPAIR l I DEMOLITION I I WOODSTOVE/FRPL INSERT 11 BUILDING RELOCATION <br />TENANT IMPROVEMENT On TN¢T� lo'n1REM ODEL ONLY v �//y)� <br />0� <br />COACT PERSON AND PHONE NO <br />WW <br />CONTRACT PRICE OF ORKq /y <br />\ Y, <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />u�Anr'P II111Ina0s. iR�„ <br />l A=ealadaR� <br />E rnoroseDusBUILDING <br />I HL9EBY 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 />LEGAL DESCnIPTION OF PROPERTY (SHOWN BELOWOR ATTACH FOUR cop IESI <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK OF _ <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 AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND t COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X <br />A <br />'.1_ ` <br />PROJECT ADDRESS a� <br />APPLIC IT S CITY BUSINESS LICENSE NO. ANB BUSINESS NA IE <br />^ Id PuJ OR -ucryO n- <br />IPLUMBING <br />MECITANICAL <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-AMNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />! <br />UNIT HEATERS-B.T.U. M <br />i <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />DISHWASHER <br />T <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />' <br />DRINKING FOUNTAIN— <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />14 <br />_ <br />HEAT PUMP <br />�— <br />BACKFLOW PREVENTERS <br />i <br />_ <br />GAS PIPING <br />' <br />ROOF DRAINS-RAINLEADERS <br />--� <br />EXHAUST FAN <br />{ <br />SINK (SERVICE -BAR, ETC.) <br />' <br />I <br />I <br />I <br />i <br />T <br />I <br />T <br />SUBTOTAL $ <br />/U -- <br />SUBTOTAL $ <br />; <br />PERMIT $ <br />/d !�' <br />PERMIT $ <br />i <br />TOTAL FEF $ <br />170' /' <br />_ <br />TOTAL FEE $ <br />�— <br />FRONT SETBACK <br />BEAR SETBACK <br />i <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />C-2 L0 lf, <br />- <br />I I YES I 1 NO <br />BUILDING <br />-------- -- <br />-' <br />TYPE OT C014ST AUDWAOLE <br />TYPE OF CONST. ACTUAL <br />IAtUMNCY <br />AO fA rNTIInmImnS <br />'R�—I <br />PLUMOINO <br />;Le ' <br />SIZE OF BLDG. <br />NO.O IORIES <br />BASEMENT � <br />MECHANICAL <br />I <br />' <br />LI YES LfN0 <br />OTHER <br />' <br />OCCUPANCY LOAD FIREBPRNKLERS REODD HEIGHT LIMITATION <br />STATE BUILDING SURCHARGE <br />LI YES <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />� <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />E <br />