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APPLICATIO. FOR CONSTRUCTIT.4111 PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT, WA 98201 A259-8810 <br />❑ DEMOUTION ❑ COMBINATION El BUILDING gI MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: RIO IC u C KeA <br />TENANT MAILADDRESS CITY ZIP 'NONE <br />ADDRESS CITY )I' 'HONE <br />CONTRACTOR MAIL <br />CONTRACTOR MAIL <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY lip PHONE STATE LICENSE <br />-)r419Uit, <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: b'G`AS El ELECTRIC ❑ <br />DESCRINE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERW4 AND PHON <br />NA F fkS J N <br />REP 60L'* <br />Ra <br />N"A1Kj i-, v� -IN GAS drQ �- <br />A L.LI �" <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 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 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 />�����1/_ <br />SI LURE DA E <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />PARCEL TAIL I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />CITY BUSINESS LICENSE NO <br />PLUM&NQ <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-AHNNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />; <br />CLOTHES WASHER <br />'WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />; <br />SINK (SERVICE - BAR. ETC.) <br />GAS PIPING <br />EXHAUSTFAN <br />i <br />QS LE <br />SUB TOTAL <br />SUBTOTAL <br />S <br />SUB TOTAL <br />SUBTOTAL $ <br />PERMIT <br />S <br />PERMIT S <br />TOTALFEE <br />S <br />TOTALFEE S <br />FOR OFFICE USE ONLY: f <br />FRONTSETBACK <br />REAR SFT6ICK <br />SIDE SETBACK <br />PLAN CIIECK NUMn[n <br />FFF <br />PFCFIPT NO <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />PURRING <br />OYES ❑ NO <br />HEIGHT LIMITATION <br />NV a DWELLING <br />SRE OF BIDGT <br />1 <br />ONI IS <br />I911MDIN^ <br />' <br />OCCUPANCY <br />NO (%SIDaCS <br />OCCUPANT LOAD <br />BASEMENT <br />MFCHANICAI <br />GROUP <br />0rE5 ❑ NO <br />i <br />T— <br />AODIIIONAI PLAN CIIFCK <br />-- <br />FIRE SPRINKLER RED 'D <br />REASON <br />oDHEn <br />— <br />FIRE ALARM REO'D <br />REASON <br />STAG BUILDING SIIncNA11GE <br />TYPE OF f.ONST <br />PLANS APPROVED BY <br />CITYOFEVERETT <br />fOnl lf. WORKS <br />— <br />LOCAL SALES <br />—'-- <br />- <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />