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APPLICATION FOR CONSTRUCTION PERMIT <br /> ot <br /> CITY OF EERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259.8810 <br /> n DEMOLITION f 1 COMBINATION R BUILDING Fl MECHANICAL <br /> PROJECT ADDRESS PLUMBING f 1 SIGN <br /> OWNER MAIL ODRF.SS <br /> �' rr GI Tr ZIP PHONE <br /> ,� P[/c' S (`rlY� 3I" I Alli%L,c>% 2So <br /> TENANT MAIL AnDFIESS <br /> CITY IIP PHONE <br /> ABL. 'F:TORDESIGNER MIL ADORESS <br /> C''ry ZIP PHONE <br /> GENEML CON 4CT0T1 AIL ADDITESS <br /> G'IT ZIP PHONE STATE LICENSE F <br /> MFCNAN/I`CALCONTRACTOR ,AVTKZ'/M ILADDRESB OTOS Kf �{ rz -,�a A�/ l r— E&��� <br /> C'ry ZIP PHONE STATE.LICENSE. <br /> PLUMBING CONTRACTON MAR ADDRESS <br /> CITY ZIP PHONE STATE LICENSE. <br /> CONTRACT PRICEO/WD IN <br /> Vrvo HEATING SYSTEM: yd GAS F1 ELECTRIC fl <br /> DESCRIBE WO K ANI SOUR E FOOTAGE ITIVOLV <br /> 2-1113/ f.ONTACf PERSON AND MIONF.NO <br /> C P,MVu ,J <br /> I HE9F,AY CERTIFY THAT I HWE READ AND EXAMINED THIS <br /> PR01'OSED USE OF BUILDING APPI•",AI!ON AND KNOW THE SAFE TO BF.TRUE AND CORRECT ALL <br /> PAC',/SIORS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH TWO CONE WORK WILL BE COMPLIED WITH WHETHER iPECIFIED HEREIN OR <br /> Lot E7�_ OF LuO� / NOT. THE GH.ANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> BLOCK 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 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 /> PARCEL TAM I D MBER CONTRACTORS LAW 147 RCW AND 290.200 WAC. <br /> CONSTRUCTION LOAN LENDER,ADDRESS.TELEPHONE NUMBER / <br /> X <br /> SIGNATURE DATE <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING <br /> NO. TYPE OF FIXTURE OR ITEMMECHANICAL <br /> FEE TYPE NO. OF EQUIPMENT FEE <br /> WATER CLOSET(TOIIE� IVC—AMMDLGUNITS—H.P. T- <br /> 9ATHTUO I FORCED AIA SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) ' <br /> ' HEAT PUMP <br /> SHOWER <br /> ' UNIT HEATERS—B.T.U. M <br /> KITCHEN SINK&DISP , <br /> I CLOTHES DRYERS <br /> DISHWASHER i <br /> ' VENTILATION FAN <br /> LAUNDRY TRAY , I <br /> CLOTHES WASHER ' RANCE HOOD , <br /> ' WATER HEATER <br /> URINAL WOOD STOVE <br /> DRINKIN3 FOUNTAIN ' <br /> METAL FIREPLACE(WOOD BURNING) ) <br /> FLOOR DRAIN <br /> BACKFLOW PFIREPLACE INSERT,WOOD BURNING) , <br /> REVENTERS ' GAS FIREPLACE i <br /> SINK(SERVICE—BAR,ETC.) <br /> ' GAS RANGE �—�— <br /> ' GAS PIPIIIO , <br /> I EXHAUSTFAN <br /> I <br /> I <br /> I , <br /> I <br /> SUB TOTAL E <br /> SUB TOTAL E <br /> PERMIT S I ___PERMIT $ <br /> TOTAL FEE S TOTAL FEE E <br /> FOR OFFICE USE ONLY: <br /> rnONT SETBACK REAn SF.TBACK SIDE SETGACK <br /> PIAN CHECK N/(Y flrn 1'FF nFCFIPT NO <br /> USE ZD I- 1 OT AREA �-- // <br /> VAC+NISRE FEES VALUATION <br /> n YES n NO I FEE <br /> 'WILDINGHEIGHT LIMITATION NO OF DWELLING SIZE OF BLDC✓TI ,5 (iO T— <br /> UNITS 1 ` <br /> PL IIMBING <br /> SF Q17 ) <br /> GCouPANCY NO(K 51(MIES OCCUPANT LOAD <br /> Z[,7 <br /> BASEMENT kFC11ANlf.Al <br /> !V A IVIES 11 NO <br /> FIRE ALARM IT v RFA" ADDITIONAL.PLAN CHECK <br /> �— <br /> FIRESPNNKIERRFOD REASON oTHEn <br /> STAIF BUILDINp 511nCHARGE <br /> TYPE OF CONST PL ANS APPROVED BY <br /> CITY OF EVERETT PURI IC WGnKS 1 <br /> %j f47 LOCAL SALES _ <br /> DALE p TAX CODE IS 3105 TOTAL <br />