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APPLICATION _ FOR CONSTRUCTI N PERMIT ll <br />Bra, EWNpresn TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett <br />BUILDING DEPARTMENT I HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />----- <br />259.8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS LI7Y NIP PHONE <br />YlkrE Lka? � 1114 V?. WA9DwyII,LE� q�74 •461 ��9� <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />CRY ZIP <br />GFNERAL CONTRAC70A <br />MAIL ADDRESS <br />CITY 21P <br />PHONE <br />NICE RISE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />LICENSE• <br />ac6c.0 f:ifz I <br />kpajaripw <br />loglo IL- NEr_ IISL <br />L -qua <br />6Z7•��4 Cc5CQ 1l�h1M <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />L17V ZIP <br />PHONE <br />LICENSE• <br />CLASS OF WORK NEW I ADDITION I � ALTERATION REPAIR DEMOLITION WnnncTnvcaaol luccor of UI n..n oc. .v...v.. <br />OO <br />CONTRACT PRICE OF WORK wool <br />CONTACTPERSONANDPHCNENO - -���-- <br />�7. <br />DESCRIBE WORK AND SWARE FOOTAGE INVOLVED <br />t2E510Ei lTI/!I. FIRe 6R4WQeW Im- <br />rROPOSEDUSEOFOUIIDING <br />51W&Lar_6WI L.Y RE.StmallIXE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED 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 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 MA E AND I COMPLY WITH THE STATE <br />CO RA TO S B. RCW AND' <br />ND 296.200 WAC. <br />SIGNRE F R 1 AU1HOi111E0 AGENT DATE <br />x <br />I",I NO AND STRESS NAME <br />LEGAL DESCAMTION OF PROPERTY (SHOWN BELOWOR ATTACH FOUR COPIES) <br />LOT BLOCK of <br />� <br />`�" I Z 5P 2G • A i <br />�'1 7 <br />Z/01. l DDHI S% �[h 5t.�iQM1�f3 �9JLUTY <br />rnaeciAnnnrss <br />021 4103W 46P• I I_ • <br />1%PLUIMBING✓FV Ji J L. GVGIGAC T• S <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS-H.P. <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />BATHTUB <br />_ _ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />DRYERS <br />SHOWER <br />_ <br />KITCHEN SINK 6 DISP <br />_ <br />_CLOTHES <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE d CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR, ETC.) <br />I <br />14- <br />t� <br />i <br />I <br />I <br />SUB TOTAL E <br />SUB TOTAL E <br />' <br />PERMIT E <br />PERMIT E <br />I <br />TOTAL FEE E <br />TOTAL FEE E <br />FOR OFFICE USE ONLY: <br />FPONi SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE�O <br />RECEIPT NO <br />37FEESS <br />19,11 <br />7 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />VALUATION <br />FEE <br />BUILDING <br />� <br />fYK OF CANTS ALLOWABLE <br />TYPE OF CONST ACTUAL <br />nfaFWO <br />Na aPA1NWG AxIf <br />cAaa <br />PLUMBING <br />I <br />SUE OF OLD(] <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />i <br />ADDITIONAL PLAN CHECK <br />OCCUPANCYLOAO FIRE SPRNKLERS REOD HEg11T lIMITATKTN <br />OTHER <br />REASON FOR SPRINKLERS <br />--T� <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />INTAKE BY <br />PlANSAPPROVED BY <br />CITY OF EVERETT <br />�IAX <br />LOCAL SALES <br />CODE IS 3105 <br />TOTAL — <br />