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APPLICATICA FOR CONSTRUCTION PERMIT "'" <br /> TO BE COMPLETED IN INK—PLEASE PRINT <br /> TM EverelPen <br /> C11 Y OF <br /> eve rett HEATING SYSTEM: U GAS U ELECTRIC U . -- <br /> BUILDING DEPARTMENT <br /> 2598810 -1`/: <br /> DEMOLITION COMBINATION BUILDING -MEGHANICAL PLUMBING SIGN <br /> Oy�ER MAIL ADDRESS CITY ZIP PHONE <br /> 1�.ta . t/ [✓ �i> a E ��_�so i //6 " rc f'.s d T 3 37- 7i rJ <br /> [� TENANT MAIL ADDRESS CITY ZIP PHpLE <br /> y AHCHITFCT ORfffiSIONER MAR ADDRESS CITY 11P PHONE <br /> IT,o x _ <br /> c 1"1 ,/� �7 3SS- <br /> _ C4 wNERALCONTRACTOR MAIL f����R� 0 / �T� �d-J)� 4 PHONE LICENSE v <br /> "[^lyy� _ l���� 2lo F•� 9�2oR <br /> MECHANICALCONTRACTOR MRADORESS CITY IP C PHONE RnBiNP272 C2 <br /> F3 71 <br /> H PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br /> y <br /> ".♦: CLASSOF WORN <br /> [xf FOS ! NEW I ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> IFO H CONTACT PERSON AND PHONE NO <br /> ^ ren CONTRACT MCC OF YARN <br /> 'nom DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> ... -- ie ..__.t.� <br /> y - PROPOSED USE OF OuIL NO I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> FA �- APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> y PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG <br /> I"I AL DEKCRIPHON OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) <br /> E7 y WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT— BLOCK OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> y O to I PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER O WHICH <br /> APPLICATION I PROPERTY PERFORM O <br /> IS MADE AND II COMPLY WITH KR THESTATE <br /> CONTRACTORS LAW 18.27 RCW AND 290.200 WAC. <br /> SIGNATURE OF CONTRA <br /> C <br /> T <br /> O <br /> R <br /> OR AUTHORIZED AGENT DATE r�9/ <br /> PROJECT ADDRESS !xv <br /> ` � �� � — ♦A AAPPLICANTS C1IY BUSINN ESS LX:ENSE NO AND BUSINESS NAME <br /> r � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> c: WATER CLOSET(TOILET) AIC–NHNDLG UNITS–H.P. ' <br /> I BATHTUB FORCED AIR SYSTEMS–B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN( _ _ I UNIT HEATERS–B.T.U. M — <br /> SHOWER ' CLOTHES DRYERS <br /> I _ KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD ' <br /> _ LAUNDRY TRAY WATER HEATER ' <br /> _ CLOTHES WASHER WOOD STOVE <br /> CRINAL METAL FIREPLACE 8 CHIMNEY <br /> ' 1�1 <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> _ FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTEI`S GAS PIPING ' <br /> I _ ROOF DRAINS–RAINLEADERS EXHAUST FAN ' <br /> j SINK(SERVICE–BAR.ETC.) <br /> I <br /> SUB TOTAL E ' SUB TOTAL S <br /> PERMIT_ E PERMIT E <br /> FE <br /> TOTAL E E TOTAL FEF. S <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK BEAR SETBACK SIDE SETBACK RAN CHECK NUMBER FEE RLCLIPI NO <br /> IISEZONE LOT AREA VACANT 6ITE FEES VALUATION FEE <br /> BUILDING _ <br /> WE OF CONTS NIOWABU TriY Or CONST ACTUAL OCC v ActivMwlRwR <br /> aRO� PLUMBING <br /> SRE OF BLDG NO OF STORIES BASEMENT MECHANICAL <br /> q I <br /> OCCUPANCY LOAD FIRE SPRNNlERS BEdD HEIGHTLIMITATION <br /> ADDITIONAL PIAN CHECK G ' <br /> UI <br /> REASON FOR SPRINKLERS I <br /> STATE BUILD( 0 SURCHARGE I <br /> INTAKE BY PLANVAPPROVEC BY CITY OF EVERETT PUBLIC WORKS <br /> �I LOCAL SALES <br /> I I TAX CODE IS 3105 TOTAL V , <br />