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J-1 <br />APPLICATIA FOR CONSTRUCT&N PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 n 257-8810 <br />❑ DEMOLITION ❑ COMBINATION fl BUILDING 0 MECHAANNICAL/ - ❑ PLUMBING El SIGN <br />PROJECTADDRESS /' / r/ 7 7 l(f� :# �1 C� �✓F fF)pl <br />/L7- %L ;f/P/fYl �iu I 7�✓ ,�%i—J 9S� <br />ARCHITECT ON DESIGNER MARADDRESS CITY ZIP PHONE <br />PLUMBING CONTRACTOR MAKADDRESS CITY ZIP PHONE STATE LICENSE• <br />wrE1RAc '=X <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SCUME FOOTAGE INIQKO <br />CONTACT PERSg1ANO PNd1E rq <br />T <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 TMF <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />FACTORS LAW 18.27 RCW AND 296.200 WAC. <br />;4ATURE <br />PROPOSED USE 01 SUIL <br />LECALDESCRIII PROPERTY RI N DELOYIOR ATTACrnvw COP I <br />LOT —BLOCK Dv <br />PMCEL IAK 10 NOMBCR <br />�� i43 AG 79017 <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />DATE <br />CITY BUSINESS LICE fSE NO <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 />AC—AHNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK 8 CISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />I METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE —BAR, ETC.1 <br />GAS PIPING <br />EXHAUSTFAN <br />I <br />SUBTOTAL <br />S <br />SUBTOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: R ni o 2 -f)SR <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />ICE <br />RECE IPTNO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />HEIGHTLIMIIATION <br />NO OF DAELLING <br />UNITS <br />SIZE OF DECEIT I. <br />P.1A <br />PCMBWG <br />CUPANCY Ifa BE SRWES <br />�wv5 A <br />OCLVPMTLOAD <br />NA <br />BASEMENT <br />❑viS aNO <br />MCHANILAL <br />ADDITIONAL PLAN CHECK <br />FIRE SPRINKLER REDD <br />N> <br />REA—B <br />OTHER <br />RALARM PEOD <br />N <br />REASON <br />ING SURCHARGE <br />TYPEa LONST <br />PLANS AP ED BY <br />hL <br />CITY OF EVERETTRnS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />rTOTAL <br />