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APPLICATIO6 FOR CONSTRUCTI%oN PERMIT CVefe'� <br /> f,,P EYP,R,"P TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY OF <br /> everett �4ATINGSYSTEM: )4GAS UELECTRIC ❑ _::::�] <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> DEMOLITION COMBINATION XIBUILDING MECHANICAL C;PLUMBING SIGN <br /> OWNE MAIL ADOEIESS fttY ('�� ZIP [PHONE <br /> TENANT I ADDRESS n 'i, .Sf2T,C/CITY Pr CV./ PHONE//(�0� (y/� <br /> AeEz OESgom. E MAZE+SyS,rATu CITY PHONE <br /> e�rnrCITY ly 44 ?.?2 -i?zy <br /> GENERAL CONTRACTOR MAA.ADDRESS 2" PHONE LICENSES <br /> -rhIn arC . 77Ylus. �Tc �jie�giuirr) 7X°Umii099.T/l <br /> MECHANICAL TIUCTOR MAR ADDRESS CITY ZIP PHONE L CENSE A <br /> PLUMBING CONTRACTOR MAA.ADDRESS CRY ZIP PHONE LICENSE P <br /> Cl SOF WORK — -- <br /> NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT C] BUILDING RELOCA PION <br /> CONTACT PERSON AND PHONE NO <br /> CONTRACT PRICE OF WORK / <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> op i II `ori Si -ir /i Mee 3S3- 4 44o7 <br /> PROPO DUSEOFBUILD c J- 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> //� IP /1,( /!.C.S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEOAI OESCRIPTgN OF PROPERTY ISIKWA BELOW OR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> Lor _T2 BLOCK OF �/Y',_6jrWV Dl� WORK WILL BE COMPLETED WITH WHETHER SFECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER ST. .OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMAI.;E OF CONSTRUCTION.THAT I AN . UTHORIZED 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 AND 296.200 WAC. <br /> SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br /> PROJECT ADDRESS ��& — <br /> APPLICANTSICITI BUSINESS LICENSE NO AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIC-A/HNDLG UNITS-H.P. I <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS-BTU. M ; <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN ; <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE B CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR URAIN _ HEAT PUMP <br /> BACKFLOW PREVENTERS X GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN _ <br /> SINK(SERVICE-BAR,ETC.) F -2 3 1_ <br /> SUB TOTAL $ SUB TOTAL $ ' <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SIDE SETBACK PLAJJCHECK NUMBER FEE 027 RECEIPTI10 <br /> #/ ) <br /> USE ZONE LOT AREA VACAN�SITE FEES VALUATION FEE <br /> BUILDING i <br /> TYPE DF WILTS ALLOWABLE IYPF CF CONST.ACIUAL .IauP.xc. NO(B fMTUTAB wn --- � <br /> uan PLUMBING ' <br /> I <br /> SIZE OF BLDG 40 OF STORIES BASEMENT MECHANICAL i <br /> i <br /> ;SCUPANCY'LOAD FIRE SPRNKLERS RECO .IGHT LIMITATION ADDITIONAL PIAN CHECK ; <br /> OTHER <br /> I <br /> REASON FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE <br /> INTAKE RY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS ' <br /> a LOCAL SALES <br /> Fara TAX CODE IS 3105 TOTAL <br />