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APPLICATI,- N FOR CONSTRUC' .ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />I7 DEMOLITION F-COMBINATION Fl BUILDING 1 UFrWAMIrAT <br />I. I awn <br />PROJECT ADDRESS <br />OWNER MAILADDRESB <br />CITY 21P PHONE <br />- n1 2 c r!. /.61 L/Wi/ Z 13 L fii6<r -9 tlo;;4�5 ?�r4 G /f 9 poi t SL -i YSa <br />TENANT MAILADDRESS CITY ZIP PHONE -- <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />CONTRACTOR <br />STATE LICENSE A <br />Z13t AliGHmr AN If, i�rr 9SIAI L - ?s-su /L/,l L".1c-± t3aoy <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS 1 t(I( `( b"rq CITY t:-p ZIP PHONE STATE LICENSE <br />P4I-f3- 41L�n�3i.✓ zSi-L�z� Ii.4L/I_=sP/6 <br />CONTRACT PRICE OF WORN <br />lgl�O 0�G` 41F ATINR CVCTC.6 I'� Iwo <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE N0. <br />AAa 0t, 3-L' 1I�' h00/rr,.- 1NSY?aL /�fl bf7 <br />i. Y i1 �iCN LYiG <br />� V oOJC��M2Rr� I NSTi9K Nf�N <br />.C19'J'/T oT,o (AN`-O/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 />PROPOSED USE OF BUILDING <br />OL,PLF'Y <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NO <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />•�' Pi <br />LOT S `� II 3 Nfciie:-! <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />BLOCK GF j <br />/W Li 30 31 <br />AUTHORITY f0 VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE <br />)'1. <br />OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 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 296.200 WAC. <br />PARCEL TAX I.D. NUMBER <br />nAND <br />� /96 <br />CONSTRUCTION <br />TION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />Pt4x <br />SIGNATURE DATE <br />CITY BUSINESS LICENSE NO 1, 3 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) i <br />I <br />A/C—A/HNDLG UNITS— H.P. <br />I <br />( <br />BATHTUB % <br />�J <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) `;. <br />—w , <br />HEAT PUMP <br />� <br />SHOWER <br />UNIT HEATERS—B.T.U. M <br />KITCHEN SINK 8 DISP <br />' <br />( <br />CLOTHES DRYERS <br />' <br />DISHWASHER <br />I <br />VENTILATION FAN <br />, <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />' <br />I <br />CLOTHES WASHER <br />WAT E IT HEATER <br />, <br />URINAL <br />' <br />WOOD STOVE <br />I <br />DRINKING FOUNTAIN <br />; <br />METAL FIREPLACE (WOOD BURNING) <br />; <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />, <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />GAS RANGE <br />' <br />SINK (SERVICE — BAR, ETC.) <br />GAS PIPING <br />' <br />i <br />yam' <br />EXHAUST FAN <br />- <br />, <br />I <br />I <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />' <br />PERMIT S <br />, <br />PERMIT $ <br />, <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />' <br />FUR OFFICE USE ONLY: i <br />FRONT SETBACK <br />' <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN C14ECK NUMBER <br />FEE <br />RECEIPT NO. <br />7-2 <br />;� <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />--� <br />nYES ❑NO <br />BUILDING <br />1 <br />' <br />HEIGHT LIMITATION-�.p�J <br />NO OF DWELLING <br />SIZE OF BLDGal <br />PLUMBING <br />UNITS, <br />S F AOPjJrdll <br />OCCUPANCY <br />GROUP <br />NO OF STORIES <br />OCCUPANTLOAD <br />BASEMENT <br />MECHANICAL <br />i <br />DYES iIl <br />' <br />ADDITIONAL PLAN CHECK <br />— <br />' <br />i_ <br />FIRE ALARM RED <br />REASON <br />OTHER <br />FIRE SPRINKLER REO'D <br />REASON <br />STATE BUILDING SURCHARGE <br />k <br />TYPE OF CONST <br />PLANS APPI1gVED BY <br />3= <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TOTAL <br />27J 1 — <br />—� <br />DATE S J Co <br />TAX CODE IS 3105 <br />