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Il <br />A��P",,,,P�LI(:ATI(od FOR CONSTRUCTION PERMIT <br />e _ � v, �/ CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98291 A 259-8810 <br />Il DEMOLITION I COMBINATION UILDING MECHANICAL. PLUMBING SIGN <br />PROJECT ADDRESS 1 I A:-V[/2CTT- WH grd<3F <br />ONMER MAIL AOLN1E55 qry rIn rHONF <br />41wsAAoo.r AfLcc�ATE.( Ic lose 11 1{«• .s.fra)�gerr WRcrPkf 3k7-EfLs7 <br />NT MAIL ATKRRFSS CITY r'P PHONE <br />nm.m u.bl un M[]IunrM <br />IAPH wul»le sti CITY 7LP <br />PHONE <br />3bil I IIPaAn�, lam_ MrAer _ y A V idf— <br />OENERAL CONTRACTOR <br />MAII A RIE55 CITY lip <br />PHONE cTATF LlCr NSF F <br />1)ak /A <br />LA-!, 101;k —)N AYE• -L v AfM yA 9gqiag <br />3K1-y6 MIL /�LoSTf <br />CHANICAL CONTRACTOR <br />MAL ADDRFSS CITY jlr <br />PHONE STATE IC NSF <br />PLUMBING CONTRAC-TW <br />MAII ADDRESS CITY ZIP <br />PHONE STATE LICENSE <br />CONTRACT PRICE OF WORN <br />— <br />HEATING SYSTEM: k GAS I I ELECTRIC FI <br />DESCRIBE V/(MK AND SQUARE FOOTAGE INV(, <br />9UILo A New nuF'Lnc <br />6�IQ <br />CONTA T PERSON AN P O14F NO <br />Qts oWAI�n 3K7- k6s7 <br />_ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORIIF;T 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 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATIO IS MADE AND I COMPLY WITH THE STATE <br />CONTR O LAW1B.27RCWAND2116.2 C <br />X <br />— <br />PIIOPOSrO USE OF BUILDING �1 <br />OLANFA dGfUPLEd rES/Of G <br />LEGAL DESCRIPTION OF PROPEFtf ( aELOWORArrACHTWO COPIES) <br />LOT aLOCK Or <br />AL,, C •E • EVERCIT WA LB <br />k <br />PARCELTAAID IuuME <br />CONSTRUCTION I GIN I ENDER AOOCESS, TFIEPHOM2 MIMSFR <br />SI(IN 'FirDART <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />A/C -At I.G UNITS -H.P. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />_ <br />WATER CLOSET (TOILET) <br />_ <br />BATHTUB ____ <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />i <br />1 <br />LAVATORY (111 II BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />' <br />UNIT HEATERS-B.T.U. M <br />_ <br />KITCHEN SINK 6 DISP <br />I <br />CLOTHES URYER9- <br />DISHWASHER <br />I <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RAI;GE HOOD <br />_ <br />CLOTHES WASHER <br />WATER HEATERURINAL <br />WOOD STOVEDRINKING <br />FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING)BACKFLOW <br />PREVENTERSGAS <br />FIREPLACE <br />SINK (SERVICE - BAR, ETC.) <br />OAS RANGE <br />OAS PIPINGEXHAUST <br />OS�: <br />FANSUB <br />TOTA <br />SUB TOTAL EPERMIT <br />PERMIT ETOTALFE <br />TOTAL FEE f <br />' <br />FOR OFFICE USE ONLY: <br />FRONT RFTRACK <br />REM SETBACK <br />SIDE SETBACK <br />PLANCHECK NUMRFR <br />r <br />FFF <br />RFCFIPT NO <br />USF ZONE <br />IOT AREA <br />_ <br />VACANT SITE <br />I'YES I' NO <br />FEES <br />VALUATION <br />FEE <br />BIRIDING. <br />^� <br />V <br />HEIGHT LIMITATION <br />NO O DWELLING <br />UNITS <br />SI OF RLOO/TI <br />76Z, 5 sf 1""V* f <br />PLUMPING <br />OCCUPANCY <br />NO M SIO'EIES <br />OCCUPANT, JAD <br />BASFMF.NTGROUP, <br />�IYFS ✓ <br />MECHANICAL <br />ADDIIONAI PI AN CHFCK <br />— — <br />— <br />"RE ALARM REO'O <br />REASON <br />_ <br />REASON <br />Y <br />CITY OF EVERETT <br />LOCAL SALES <br />=1112?_'.> TAX CODE IS 3105 <br />OTHER <br />FIRE SPRINKIFR RFOp <br />STATE 001WINLI SIR CHA R(IE <br />TYPE OF CONST <br />�-V <br />coal K: vromcs <br />' <br />TOTAL <br />-- <br />___ <br />---- <br />