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APPLICATIO1a FOR CONSTRUCTWoN PERMIT everett <br />EH��R en TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett I HEATING SYSTEM: U GAS U ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />n.P. MAIL ADDRESS CITY 21P PHONE <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />� A.� <br />w"4 Co <br />( As (d <br />k- O Bo)C <br />10 <br />�! ✓14 - -'Lim <br />MAIL ADORES. <br />CITY <br />ZIP <br />PHONE <br />QRCH'TECTOADESIGN tR <br />GENERAL CONTRACTOR <br />... .r I �. <br />MAIL ADDRESS � <br />tea,.' I, cam. <br />CITY <br />Tti-/- <br />21P <br />4�e,/ <br />PHONE LICENSE• <br />'33A_4:?�►n to)A- EI,&/41FA <br />L <br />PLUMBING CONTRACTOR MAIL ADDRFSS <br />CITY <br />CITY ZIP <br />PHONE <br />CLASS OF WORN <br />7 NEW ' ADDITION )C ALTERATION REPAIH DEMOLITION WOODSTOVE/FRPL INSERT . - BUILDING RELOCATION <br />TRACT PRICE OF WORK a 17s0-ra <br />CONTACT PERSON AND PHONE NO <br />DESCRIBE WORK AND SCARE FOOTAGE INVOLVED <br />P <br />f <br />_ /G '• lt <br />PBOPOSEDUSE OF BUILDIN r�Gr✓,�fi�u• <br />�^ .0 3 <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 PRESUME 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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN B LOW OR ATTACH OUR COPIES) <br />Lot BLOCK OF <br />PROJECT ADDRESS <br />I <br />APPLICA TS CITV BUS NESS LICEIJSE NO AND BUSINESS NAME <br />PLUMBING <br />MECHAtAICAL <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—A/HNDLG 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 />LAUNDRYTRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNjlY <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 />SUBTOTAL <br />$ <br />SUBTOTAL $i_ <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />Cll�t I ICC null V• <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />)77'00 <br />TYPE OF CONTS ALLOWABLE <br />TYPE OF CONS). ACTUAL <br />=U144CY4 <br />NO a MELUNG III I9 <br />GRWL <br />PLUMBING <br />i <br />—� <br />SIZE OF BLDG. 3rp �,1� <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />' <br />HEIGHT LIMITATION <br />OCCUPANCY LOAD FIRE SPRNKLERS HEO'D <br />OTHER <br />T <br />REASON FOR SPRINKLERS <br />o <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVER <br />PUBLIC WORKS <br />_ <br />�� <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />7d <br />i <br />