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way <br />APPLICATIO►r,FOR CONSTRUCTI"N PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS U ELECTRIC U - <br />�'N9-8810 <br />CI DEMOLITION I_ I COMBINATION I I BUILDING MECHANICAL I PLUMBING 1_I SIGN <br />c'Y ZIP rrroNE <br />TENANT / MAZE AD`D�R�E/�SS/��j�� CITY <br />ARCHITAQA!!lnJVDESIGNER <br />�O . 1 DRESS / �TCITY zip PHONE �` <br />CONTRACT PRICE OF WOTIK <br />W <br />6VO L�e�ar <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED// <br /># I �� <br />CONTACTPLRSON AND PrroNE No <br />400 AL <br />9Ameaws <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED <br />USE OF BUILDING <br />/ <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALI- <br />/P /ki <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL'JESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH IWO COPIES) <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 I COMPLY WITH THE STATE <br />PARCEL TAX I.D. NUMBER <br />CONTRACTOP.S L W 18.27 RCW AND 296.200 WAC. <br />CONSTRUCTION LC1N LENDER, ADDRESS, TELEPHONE NUMBER <br />4. <br />. aii <br />OJECT <br />AD ESS <br />TMTL <br />/r� <br />_ <br />I e,rsMFxs�rrr tiv�l <br />PL111mt0 <br />INECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />HO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS- H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. hl E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />, <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />; <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />_ <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAINS-RAINLEADERS <br />�- <br />EXHAUSTFAN <br />, <br />SINK (SERVICE -BAR, ETC.) <br />I <br />r <br />, <br />i <br />SUB TOTAL $ <br />SUBTOTAL E <br />' <br />PERMIT S <br />PERMIT $ <br />S; <br />TOTAL FEE S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN LHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />YES I NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />' <br />TYPE OF CONST <br />NO. OF STORIES <br />occwFx[r Iq oln rtuxc cans <br />woln <br />- <br />PLUMBING <br />- <br />SIZE OF BLDG. <br />FIRE SPRINKLERS RED D <br />34CGENT <br />❑ YES CI NO <br />MECHANICAL <br />�— <br />, <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM RE00 <br />HEIGHT LIMITATION <br />OTHER <br />) <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APP VED BY <br />J <br />DATE I) _ 1� - <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />P <br />N <br />