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APPLICATIOd FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />91'12a /_200 CEDAR STREET • EVERETT, WA 98201 •'459.8810 <br />fl DEMOLITION (1 COMBINATION rl BUILDING n MECHANICAL I PLUMBING I 1 SIGN <br />PROJECT ADDRESS <br />ZIP PHONE <br />I l t t MAI' <br />L\ <br />GENERAL CONTRACTOR MAILADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE• <br />'�2�Lev <br />-�ulIt. ?c.30. tl�S <br />S'ra>vtoAIA4 <br />`1fdgr <br />MECHANICALC NTRACTOR MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE• <br />PLUMBING CONTPACTOR MAIL ADDRESS <br />4-wt.e L <br />CITY <br />riz3z Tom:++. <br />ZIP PHONE <br />IlL1r. A e <br />STATE LICENSE• <br />Eri�eoOA^lte,4 <br />CONTRACT #RICE OF WORK <br />HEATING SYSTEM: f l GAS FI ELECTRIC fl <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 />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 AUTHORIZtD BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />%�R Ai.%QR$k'AW 6. � W AND 296.200 WAC�. n <br />i�-(XI////� /,f-/O - C <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIESI <br />LOT' BLOCK OF <br />PARCEL TAX I,D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />SIGNATURE vDATE <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL _ <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />A/C —A/HNDLG UNITS —H.P. <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />; <br />S <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />I <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M <br />/ <br />KITCHEN SINK & DISP <br />CLOTHES DRYERS <br />i <br />DISHWASHER <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />; <br />/ <br />CLOTHES WASHER <br />WATER HEATER <br />/ <br />URINAL <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE —BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />i <br />EXHAUST FAN <br />i <br />SUBTOTAL $ <br />i ; <br />i7 SUB TOTAL $ <br />L ; <br />PERMIT $ <br />) I <br />PERMIT $ <br />i <br />✓ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />READ SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FFF <br />RECEIPT NO <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />�— <br />I <br />I <br />_ <br />nves r No <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />SIZE OF BLDG?I <br />I <br />lRllis <br />PLUMBING <br />- T <br />OCCUPANCY <br />NO OF STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />' <br />GROUP <br />I <br />((YES !I ND <br />ADDITIONAL PLAN CIIFCK <br />_ <br />i <br />FIRE ALARM REOD <br />RFASON <br />OTHER <br />FIRF. SPRINKIERREO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />TYPE OF OONST <br />PLANSAPPROVED BY <br />CITY OF EVERETT <br />PUBLIC, WORKS <br />LOCAL SALES <br />1 <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />