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APPLICATIC'1 FOR CONSTRUCT -IN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8810 <br />❑ DEMOLITION J COMBINATION i I BUILDING ❑ MECHANICAL i PLUMBING )6�SIGI <br />0 <br />MAIL <br />ADDRESS �o <br />MAIL ADDRESS <br />MAIL ADDRESS <br />In <br />LITY <br />I a <br />ZIP <br />NINIL nLIUXCJJ CITY ZIP <br />S((oN 170" ")Z# N <br />MAIL ADDRESS CITY ZIP <br />MAIL ADDRESS CITY ZIP <br />�w5,—ivy <br />IZ- <br />STATE LICENSE <br />3 slbR-Es ,� �IpJc <br />STATE LICENSE <br />STATE LICENSE A <br />CONTRPgICE OF WORK <br />DESCRIBE 1*( AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />I 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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PP.ESUME 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 />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC, <br />�r <br />PROPOSED qBJE OF BUILDIIA <br />LEGAL DESCRIPTION GIE PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES) <br />LOT— etocK of — <br />PARCEL TAX ID NUMBER <br />"01Z — av <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />�'131�QdCfGPi <br />s� �IfI� <br />Cli U INf SL ENSE NO <br />PLUMI <br />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 />A/C—AHNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK & 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 />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />; <br />SUBTOTAL $ <br />B TOTAL $ <br />PERMIT $ <br />I. �_ PERMIT $ <br />TOTALFEE $1 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FROtj74ETBACK <br />�SETBA/,x/1 <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />- <br />"j G <br />RECEIPT NO <br />3 <br />2 <br />71 <br />USE ZONE <br />LOT /LREAS� <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />' <br />'-L <br />!i <br />❑ YES � NO <br />BUILDING <br />; - <br />TYPEOFCONST <br />NO. OF STORIES <br />MCUMNCr <br />NO OION'fUINGMTS <br />PLUMBING <br />OINK <br />SIZE OF BLDG. <br />FIRE SPRINKLERS REO'D <br />BASEMENT <br />MECHANICAL <br />❑ YES 1-1 NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM RED <br />HEIGHT LIMITATION <br />1S <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANSAPPFOVEDBV <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />rout <br />DATE <br />TAX CODE IS 3105 <br />