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APPLICATION FOR CONSTRUCTION PERMIT <br />everett <br />NB FV9RJIBf1Ii <br />cln of <br />everett <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK —PLEASE PRINT <br />Ll DEMOLITION 1 COMBINATION I BUILDING i I MECHANICAL I I PLUMBING 1 SIGN <br />I? <br />3ENERAL CONTRACTOR MAIL ADDRESS CITY ZIP " PHONE LICENSEE ' <br />MECHANICAL CONTRACTOR MAIL ADDRESS :ITY ZIP PHONE LICENSER <br />rl NEW n ADDITION V ALTERATION ( ) REPAIR ❑ DEMOLITION 1 ! WOODSTOVE/FRPL INSERT L 1 BUILDING RELOCATION <br />TENANT IMPROVEMENT OR INTERIO�fl (Q—EM//OO�DEL ONLY <br />CONTRACT PRICE OP WORK: tA; Pl �/ <br />CONTACT PERSON AND PHONE NO. <br />DESCRIBE WORK ND SQUARE FOOtAGE INVOLV <br />PROPOSED USE F�BjUILJDINO <br />��f�l <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 ORDINANCFiS 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 CANCE- 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 PERTY TO PERFORM THE WORK FOR WHICH <br />APPLE ION IS ODE AND i COMPLY WITH THE STATE <br />CONTAACTORSLA7 RCW A �36.200 WAC. <br />SIGNATAUTHORIZ 0 CENT DATE <br />A' <br />AP PL ICANTS CITY BUSINE SS LIC EN E E NO AND BU ESS NAME <br />MECHANICAL <br />LEGAL DESCRIPT.ON OF PROPERTY ISM WN BELOW OFI F R OPIES <br />LOT BLOCK - OF <br />_ Z,4 <br />_ - <br />PROJECT ADDRESS <br />/•1� C:Q I <br />� Lll <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />CLOSET (TOILET) <br />A/C -A HNDLG UNITS-H.P. <br />�— <br />TWATER <br />BATHTUB <br />;'� <br />FORCED AIR SYSTEPAS-E T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />i= <br />UNIT HEATERS-B.TU. III <br />i <br />SHOWER <br />CLOTHES DRYERS_ <br />' <br />KITCHEN SINK 8 DISP <br />C� ; <br />VENTILATION FAN <br />DISHWASHERS <br />^ <br />RANGE HOOD <br />LAUNDRY TRAY <br />'-' <br />WATER HEATER - <br />CLOTHES WASHER <br />WOOD STOVE _ <br />URINAL <br />METAL FIREPLACE & CHIMNEY <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 />_ <br />SUB TOTAL <br />$ <br />' <br />SUB TOTAL $ <br />' <br />PERMIT <br />$ <br />-T^ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />`T <br />TOTAL FEE $1 <br />El <br />FRONT SETBACK <br />REAR SETBACC <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />I ) YES 11 NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />1 <br />i <br />TYPE OjS=T ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />V —Al <br />ox':gp N[r <br />7W 3 <br />I NO OF DWELLING UNITS <br />SIZE CF BLDG <br />��(% �✓ <br />NO. OF STORIES <br />BASEMENT <br />LI YES L O <br />MECLiANICAL <br />! <br />' <br />— — <br />JTHER <br />I <br />OCCUPANCY LOAD FIRE SPRINKLERS TIED <br />/y 1-1 YESNJ <br />REASON FOR SPRINKLERS <br />F.EIGHTLIMITATION <br />STATE BUILDING SURCHARGE <br />S'iATE ENERGY SURCHARGE <br />i <br />AFPLICATIONACC. ON <br />PLANS APPh BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />— <br />TorAL <br />^^ <br />I <br />I <br />1 <br />1 <br />I <br />1 <br />I <br />