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APPLICATION FOR CONSTRUCTI%.H PERMIT <br />everett <br />the EVe.pmen <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />HEATING S`.'STEM: ❑ GAS <br />ELECTRIC ❑ <br />259-8810 <br />1 1 DEMOLITION <br />i I COMBINATION 1J BUILDING <br />G MECHANICAL CI PLUMBING I-1 SIGN <br />OWNER <br />P Eucierr <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />a 2F <br />/ G <br />�x 5�S IyErEt� 98�G6 <br />�5 3r�9 <br />TENANT <br />II <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />�I LT <br />GT Ir <br />ARCIIITE�C�T O�R� DESIGNER <br />MAIL ADpRE55 <br />CITY <br />ZIP PHONE <br />XdS' SIVAV A�nM1T60FURE <br />9 16 P T!c Lr, rcic`,��77" <br />`>S�Cy Za:Z-G5'�1S <br />GENERAL CONTR CTOR <br />7� <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />LICENSEE <br />�AK15AklIYAKISAKI <br />JV 13(1 <br />�c 5iFbalL <br />OJ.�/'/4 l&-4g45- <br />/lA`rhk'/-/,�13 A <br />MECHANICAL C TRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />LICENSEE <br />PLUMPING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />LICENSE E <br />...•.aa v� -�nl - <br />IYr NEW I ADDITION 1 1 ALTERATION f 1 REPAIR I nrmnI ITInM I I ulnnnem+,v,rno r 1 •••• ... __. __._._.. <br />� z�Q <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORK lA{.Uy� <br />� <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Yn1AA1r ZWp AI 1 KIYS , T¢`i. _All1� <br />/ 1[ I, <br />'69-916.1- <br />PROPOSEDUSE OFBUILDING <br />j`]/-mu 57, F. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />9 16 <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES)) <br />LOT BLOCK of <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />5mrlom 307-c;5 <br />? 5 ^ <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 (' L <br />.I.L;e�i-G.AJf/ t) �I l / L <br />PROJECT ADDRESS <br />2 r j vE. —G'r6nz <br />/ <br />E!<.� <br />APPUCAf<lTS CIT Bd FSS LICENSE NO AND BUSIkPM NAMEr <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—AIHNOLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />; <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />ICLOTHES <br />DRYERS <br />, <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />' <br />DISHWASHER <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />' <br />NATER HEATER <br />CLOTHES WASHER <br />�- <br />WOOD STOVE <br />_ <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAI <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW P VENTERS <br />GAS PIPING <br />I <br />ROOF DR S—RAINLEADERS <br />EXHAUST AN <br />SINK (S VICE —BAR, ETC.) <br />, <br />i <br />' <br />T <br />SUBTOTAL <br />$ <br />SUB TOTAL $ <br />' <br />_ <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />_ <br />REARSETBACK <br />I ST 1 <br />SIDE SETBACK <br />— <br />PLAN CHECK NUMBER <br />7G• ,C <br />FEE <br />RECFIPT NO. <br />USE ZONE <br />M <br />LOT AREA <br />VACANT SITE <br />/jo <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />2 ) <br />0 <br />TYPE OF CONTS. ALLOWASI E <br />TYPE DL CONST. ACTUAL <br />ocCurnrtv <br />NOOIONILNGUNII$ <br />PLUMBING <br />SIZE OF BLDG, <br />NO, OF STORIES <br />BASEMENT <br />U <br />MECHANICAL <br />' <br />ADDITIONAL PLAN CHECK <br />' <br />OCCUPANCY LOAD <br />REASON FOR SPRINKLERS <br />FIRE SPRNKKLLEEPS RED <br />HEIGHTLIMITATION <br />OTHER <br />i <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />4 <br />ry <br />INTAKE BY <br />PLANS APPROVEDBY <br />II 2 9L JM <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />L <br />