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C <br />APPLICATILA FOR CONSTRUCT wJN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 K259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL <br />❑ PLUMBING F-1 SIGN <br />PLUMBNGCONTRACTOR MAq ADDRESS CITY ZIP PHONE <br />� STATE LICENSE L <br />CDNTRACT PEACE OF _ — <br />7 <br />HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br />DESCRIBE WORK AND SOIIARE FOOTAGE INVOLVED <br />CONTACT PERSONAND PHONE NO <br />/ <br />! O <br />/ <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSED LLSE OF BUILDING <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 />LEGAL DE OCRPT10N OF P"OPERTY (SHOWN BELOW OR ATTACHTWOCONESI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <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 I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MAD"ND 1 COMPLY WITH THE STATE <br />CONTRACTORS LA 27 FI D 6.200 WAC. <br />FARM rIU(tD. NUAlER <br />X <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NAIBER <br />SKiNATU DATE <br />CITY BUSINESS LICENSE NO <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 />' <br />A/C-AIHNDLG UNITS <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS <br />LAVATORV(WASH BASIN) <br />HEAT PUMP <br />SHOWER' <br />UNIT HEATERS <br />I <br />KITCHEN SINK 8 DISP _ <br />; <br />CLOTHES DRYERS <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />1 <br />WOOD STOVE <br />, <br />_ <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />, <br />BACKFLOW PREVENTEgS <br />; <br />GAS RANGE <br />I <br />SINK (SERVICE - BAR, ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />L- <br />i <br />SUB TOTAL $ <br />' <br />SUB TOTAL $ <br />) <br />PERMIT $ <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REARSFTBACK <br />SIDE SETBACK <br />PUN CHECK NUMBER _ <br />IEF <br />RECEIPT NO <br />� <br />USE ZONE <br />Lot AREA VACANT SIfF. <br />FEES <br />VALUATION <br />FEE <br />DYES ❑ NO <br />BUILDING <br />' <br />HEIGHT LIMITATION <br />NO OF DWELLING SITE OF BLDGRI <br />i <br />UNITE <br />PI UU11ING <br />OCCUPANCY <br />w m ""'T' S <br />OCCUPANT LOAD <br />BASEMENT <br />—� <br />GROUP <br />MECHANICAL <br />OYES ❑NO <br />Al$NIIDNAL PLANCHUCK <br />— <br />FIRE SPRINKLER REO'D <br />REASON <br />OIHER <br />FIRE ALARM REO'D <br />REASON <br />STALE BUILDING SURCHARGE <br />TYPE OF f,ONST <br />PI ANS APPROVE D BY <br />CRY OF EVERETT <br />PURIIc woms <br />LOCAL SALES <br />`_ <br />TOTAL <br />----- <br />- <br />uAIE TAX CODE IS 3105 <br />