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APPLICATA FOR CONSTRUCAN PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET A EVERETT. WA 98201 A 257.8810 <br />❑ DEMOLITION ❑ COMBINATION LAB WILDING ❑ MECHANICAL ❑ PLUMBLVG ❑ <br />CITY <br />ARCHITECT DR MSC14ER <br />PHONE <br />CONTRACT (NICE Of WORrc <br />HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />DESCRIBE WOPKAND SQUARE FOOTAGE IMlavm <br />CONTACT PERSON MID PHONE la <br />o z- <br />ti u 0;;'& 937 y107 <br />1 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 GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY 10 VIC'i..="f OR CANCEL THE PROVISION OF ANY <br />OTHER STATL D; i 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 WAD. <br />�i�� �-7-OO <br />X D A i�ys}—� /- <br />SIGNATURE DALE <br />CITY BUSINESS LICENSE IAI. <br />PROPOSED USEDFBU11.01 Q <br />'0' <br />LEGALBEwRwTIQN ERTYISHOWN BELDWORA11A 31 TWOCOPIES1 <br />LOT BLOCK OF <br />FMICEL TAXI D. NUMBER <br />511Mir Al o <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <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—0.'HNDLG UNITS <br />BATHTUB <br />! <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />I <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIRE_PLACE(NOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (W'JOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR, ETC.I <br />i <br />GAS PIPING <br />EXHAUSTFAN <br />I <br />SUBTOTAL <br />5 <br />SUB TOTAL S <br />PERMIT <br />S <br />I <br />PERMIT S <br />TOTAL FEE <br />5 <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />I7ETBALI A <br />PEAPSETBACA <br />SOE SEi/U04;/O�MA <br />'J <br />FIAN LIELx MI [Rgg <br />JA/yy"1 <br />FEE,1l l' <br />(iV1ALLU�ATION <br />PLCEIPi ISO <br />USEZME/J C <br />AI(�• J <br />LOT MICA ��( <br />OETJ if <br />VACCM RE <br />❑YES NO <br />FEES <br />FED=. <br />No MNG <br />IZ <br />TIC <br />HEIGHTLIMITATIO�I <br />/ S <br />OF DWiU.INQ <br />ND OF <br />UNITS ( <br />SQEOFBLCIITI. <br />e S F <br />RUMBIIq <br />�- <br />QCUPANCY NO CiIlO S <br />v_1 <br />OCCUPANT LOAD <br />BASEMENT � � <br />❑YES Li$I, <br />MECHANICAL <br />—� <br />ABBITIONALPLAHCHECK <br />FIRESPRINKLERREOD <br />REASON <br />OTHER <br />HREALARMREO'D <br />fuURN <br />STATE BUUDnq SURCHARGE <br />TYPE OF CONST <br />_�_ <br />PLANSAPPROVED BY <br />DATE TO qp <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 310S <br />PUBLCMAIS <br />TOTAL <br />