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APPLICATIG_J FOR CONSTRUCT.JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET I EVERETT, WA 98201 •259.8810 <br />DEMOUTION ❑ COMBINATICI❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />O PROJECT ADD -3 12 I 5- *tT V8& Z' <br />ILI O V V I <br />ZIP <br />ARCHITECT OR DESIGNER <br />vc TAAII AIA➢RJ] CITY ZIP PHONE STATE IICENSE [ <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE F <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />SCIIBE AND SOU F TADE MVOLVED 7� // ,, <br />CONTACT PERSON AND PHONE NO <br />K 7cv ,, Ft--, <br />1 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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 0Y THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW11, RCW AND 296.2DO WAC. <br />Y <br />,PROPOSED USE OF BUILDING <br />I <br />,LEGAL DESCRIPTION OF PROPERTY Iss__fHfQNN BELOW Oft TTAGH rvroc SI <br />RT���[[/W <br />LOT _� BLOCK 7 of 7 B7 V 6- <br />_ <br />e <br />,q+wcEt TAX I.D. NUMBER <br />CONSTRUCTION LOIN! LENDER. ADDRESS. TELEPHONE NUMBER <br />SIGNATURE DATE <br />CITY SUSNESS LICENSE NO <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—AMNDLG UNITS <br />' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS <br />' <br />LAVATORY (WASH BASIN) <br />T <br />NEAT PUMP <br />, <br />SHOWER <br />' <br />UNIT HEATERS <br />' <br />KITCHEN SINK IL DISP <br />; <br />CLOTHES DRYERS <br />DISHWASHER <br />_ <br />RANGE HOOD <br />T <br />LAUNDRY TRAY <br />I WATER HEATER <br />; <br />_ <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />' <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />; <br />SINK (SERVICE — BAR. ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />_ <br />SUB TOTAL $ <br />SUB TCTAL S <br />_ <br />PERMIT S <br />PERMIT 5 <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK <br />REAR GF.TBACK <br />SIDE SETBACK <br />PI AN CHECK NUMBER <br />FFF <br />RFCFIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUR DING <br />- <br />❑YES ❑ NO <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGRI <br />UNITS <br />PI IIMflINf, <br />OCCUPANCY <br />NO OF51(VMfS <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />GROUP <br />- <br />❑vE5 ❑NO <br />AODIDONAI PI AN CHICK <br />--- <br />FIRESPRINKLFRREG'D <br />REASON <br />OTHER <br />FIRE ALARM RED <br />11FAS061 <br />STATE BOII DING SURCHARGE <br />TYPE OFfONSi <br />PIANSAPPPOVED By <br />CITY OF EVERETT <br />Pllflt IC WORKS <br />-- <br />LOCAL SALES <br />-- --- - — - <br />--- <br />TAX CODE I5 3105 <br />TOTAL <br />r,eTE <br />__ <br />`_ <br />