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APPLICATIC 1 FOR CONSTRUCT' 1N PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />HEATING SYSTEM: J GAS J ELECTRIC J <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION L! COMBINATION BUILDING MECHANICAL -PLUMBING SIGN <br />OWNER ESS ♦ �T �' <br />, PHONE <br />I,TD9 ADD deX /��2 —' - ^,. n /w <br />TENANT <br />MAIL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE A <br />PLU / t�AwN'R. CT,R • <br />' MAIL AD�n � I ' <br />CITY <br />/I�� <br />/�//,PHON1 <br />♦ STATE LICENSE <br />IF Allff&ff4 <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK 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 />PROPOSED USE OF BUILDING <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOW'J BELOW OR ATTACH TWO COPIES) <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK- OF <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 />PARCEL TAX I D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBE <br />PROJECT AD <br />crt u Nssuccnsc No <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />ATC-A'HNDLG UNITS-H.P. <br />AIR SYSTEMS-B.T.U. M E.A. <br />BATHTUBFORCED <br />19 <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />i <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />.� <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />•t <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />AS <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />;i <br />GAS PIPING <br />RAINSRAINLEADE <br />EXHAUST FAN <br />mmz. <br />SUBTOTAL $ <br />_ <br />PERMIT $ <br />TOTALFEE $ <br />TOTAL FEE $ <br />FUH Uh-Flla USC <br />FRONT SETBACK <br />UIYLT: <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER FEE <br />RECEIPT 110. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES- NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE CTCOtST. <br />NO, OF STORIES <br />=urANcr <br />G4W, <br />Nu of MUNC UNITS <br />PLUMBING <br />i <br />MECHANICAL <br />_ <br />SIZE OF BLDG, <br />FIRE SPRINKLERS RED <br />BASEMENT <br />❑ YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />_ <br />OCCUPANCY LOAD <br />FIRE ALARM REO'D <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />INTAKE By <br />PLANS APPROVED By <br />CITY OF EVERETT <br />LOCAL SALES <br />- <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />1 <br />