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APPLICATIGA FOR CONSTRUMON <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-BB10 <br />fl DEMOLITION f I COMBINATION I I BUILDING n MECHANICAL <br />PROJECT ADDRESS /&' / C' Gs -5 <br />ONMERL MAIL ADDRESS <br />S°p/T%iY✓ CITY ZIP PH <br />Al 1616.6?K? 5T•5c= cvtRti'T' <br />TENANT MAIL ADDRESS CITY ZIP <br />rH <br />ARCHITECT OR OESONER MAIL ADDRESS r•RY �,,, _ <br />PERMIT <br />�* <br />1 1 PLUMBING I I SIGN <br />ZOG) 3472-1Li <br />PLUMBING CONTRACTOR MAIL ADD-RESS CITY ZIP <br />PIKRlE SPATE LICENSE F <br />WORK AND SOLTARE FOOTAGE INVOLVED <br />9M <br />LOT . '�?.� BLOCK <br />3 i 7 00 0011- <br />CONSTRUCTION LOAN (ENDER. AODDESS. TELEPHONE NUMBER <br />HEATING SYSTEM: I I GAS TA ELECTRIC n <br />CONTACT PERSON AM WIIUx w <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 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 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 />CONTRACTORS L 18.27 RCW AND 296.200 WAC. <br />SIGNMUn DATE <br />Cltt BUSINESS LOENSC NO <br />NO. <br />TYPE OF flXTURE OR ITEM <br />mcbnwnlMgL <br />FEE N0. <br />FEE <br />WATER CLOSET (TOILET) <br />_TYPE OF EQUIPMENT <br />BATHTUB' <br />LAVATORY (WASH BASIN) 11 <br />' <br />A/C—ARiNOLG UNRS—H.P. <br />FORCED AIR SYSTEMS —B.TU. M E.A. <br />' <br />SHOWER <br />I <br />HEAT PUMP <br />KITCHEN SINK 8 DISP <br />' <br />I <br />UNIT HEATERS — B.T.U. M <br />I <br />DISHWASHER <br />1 <br />CLOTHES DRYERS <br />' <br />' <br />LAUNDRY TRAY <br />' <br />VENTILATION FAN <br />� <br />I <br />RANGE HOOD <br />1 <br />CLOTHES WASHER <br />' <br />WATER HEATER <br />' <br />URINAL <br />' <br />WOOD STOVE <br />� <br />DRINKING FOUNTAIN <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />1 <br />FLOOR DRAIN <br />' <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />I <br />BACKFLOW PREVENTERS <br />' <br />GAS FIREPLACE <br />1 <br />SINK (SERVICE —BAR. ETC.) <br />I <br />GABRANGE <br />1 <br />' <br />GAS PIPING <br />I <br />I <br />EXHAUSTFAN <br />1 <br />1 <br />I <br />, <br />SUB TOTAL f <br />SUB TOTAL f <br />1 <br />PERMIT f <br />I <br />hERMIT f <br />1 <br />TOTAL FEE S <br />' <br />TOTAL FEE f <br />' <br />.. vrrwla UJC UPILT: <br />FRONT SETBACK <br />IISFZ <br />DEAD SETBACK SIDE SETBACK <br />POT AREA VACANT SITE <br />Pl ANC11EC MILER FEF/(i <br />w'��� <br />FEES <br />UJA(' I <br />VALUATION <br />RECEIPT NO <br />FEE <br />nrrs 1; NO <br />NO OF DY/F.IUNG <br />UNITS SIZE OF RL IK,I I <br />BUtIDING <br />/ <br />HEIGHT (IMITATION <br />� <br />OCCUPANCY mo N Stfm,% <br />ORour n <br />20 f <br />OCCIIPANI IOAD RA�EMENT <br />4�L / <br />IIYFS IVIp <br />PLUMBMO <br />MECHANICAL <br />FIREALAnMnEOD <br />REASON <br />ADDITIONAL PLAN CHECK <br />1 <br />OTHER <br />FIRE SPRINKIFRnEOO <br />REASON <br />STATE Will. DING SURCHARGE <br />ttrraroNs <br />PLANS APPPOWDBY <br />cif' <br />CITY OF EVERETT <br />rumK wGnKv <br />DATE 814A5TAX <br />LOCAL SALES <br />CODE IS 3105 <br />---- <br />' <br />TOTAL <br />_ <br />