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APPLICATIC A FOR CONSTRUCT 13N PERMIT <br />CITY OF EVERETT I BUILDING DIVISION <br />3200 CEDAR STREET I, EVERETT, WA 98201 I259.8810 <br />❑ DEMOUTION ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: 300`3 G /N � u- <br />o �Z ? <br />%�ncr in/Cz C'o. , /�._D, G'vx 07 /Lt so� S�r� /i^G� w-s' c3��zy <br />Ji_ <br />MAIL <br />5T/ <br />1,11 PHONE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />TIP <br />PHONE <br />SLATE LICENSE <br />— <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />TIP <br />PHONE <br />STATE LICENSE <br />CONTRACT PRICE OF WORK +-a F <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SOUARE F60TA09 INVOLVED <br />CONTACT PEOsON AND PHONE NO <br />�. 1)19 IZENO V/}jg" &A/.5 r/NC f-cocR-S <br />Sj ZjOS <br />Al HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />PROPOSED USE OF BUILDING <br />�I� �6 <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIESI <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCKDF <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 />CONT CTORS LA ie.27 RCW AND 296.200 WAC <br />Y, —� <br />SIGNAN DATE <br />PARCEL TALI I D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />FEE <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT <br />FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />' <br />WATER CLOSET (TOILET) <br />AIC—AMNDLO UNITS <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />SHOWER <br />I <br />UNIT HEATERS <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />' <br />DISHWASHER <br />' <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />METAL FIREPLACE (W(5OD BURNING) <br />URINAL <br />FIREPLACE INSERT (WOOD BURNING) <br />) <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />— <br />—�— <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />i <br />SUB TOTAL f <br />':=q— <br />SUB TOTAL f <br />T_ <br />PERMIT S <br />, <br />PERMIT f <br />' <br />TOTALFEE f <br />' <br />TOTALFEE f <br />' <br />_ <br />FOR OFFICE USE ONLY: <br />rnON; SETBACK <br />REAR SETBACK <br />SIDE SE iBACK <br />PLAN CHECK NUMOF77 <br />r6 <br />Rrf.E1P1 NO <br />3 77G <br />USE TONE <br />JUT AREA <br />VACANT SUF <br />EI NU <br />_- <br />FEES <br />- <br />VALUATION <br />_ <br />FEE T_ <br />' <br />❑YES <br />DIIII DING <br />.- <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SITE OrQ BLDGII I1'� <br />UNITS <br />� V <br />I �� V — <br />i'111MPIN(=--_- <br />_ <br />_- T <br />MECHANICAL <br />OCCUPANCY <br />OR pUP <br />NO Of!7VM <br />L.I✓F, <br />OCCUPANT LOAD <br />BA MENT <br />ADUITIONAI PLAN CHICH <br />--------- <br />Jt <br />, <br />/ I <br />i 1 <br />[]rEs ❑ NO <br />' <br />FIRE SPRINKLER REO'D <br />REASON <br />./fir j <br />p�10 __ <br />GNrzn <br />FIRE ALARM REO'D <br />REASON <br />STAI r B1II101NG S11RC11ARGE <br />Pun, IC WOOKS <br />TOTAL <br />---- <br />, <br />TYPE Or CON%TT / <br />PLANS Arr Y(DBY CITY OF EVERETT <br />LOCAL SALES---- <br />nAIF �— i 1. TAX CODE IS 3105 <br />— <br />