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APPLICAT16N FOR CONSTRUC rl''iON PERMIT 1l0 BE COMPLETED IN INK -PLEASE PRINT <br />cIIY 01 <br />everett HEATING SYSTEM: AS ❑ELECTRIC ❑ I <br />BUIL DING DEPARTMENT <br />259-8810 <br />I DEMOLITION I I COMBINATION I I BUILDING ('I MECHANICAL l PLUMBING I SIGN <br />HONE <br />�� 1111 1�ADDRE-,, <br />�j r� � St 2- 1� .�3 z `�3 <br />IFNl1{(n CITY ZIP PHONE <br />ARCPIIECr On PES GNER MAIL ADDRESS GIIY ur 1-1. <br />PLUMBNGCONRIACTOTI LIAR ADDRESS CITY ZIP PHONE LICENSEE <br />CLASSOF WORK --11 _ <br />I .Hrw 1 1 Anrnnnu l1 Al TcaerlGN 1 1 REPAIR I I DEMOLITION I I WOODSTOVEIFRPL INSERT L l BUILDING RELOCATION <br />U <br />CONTACT PERSON AND PHONE NO. <br />CONI RACT PACE OF WORK I/+f-�C/j^/ <br />DESCRIBE K 1 - ARE FOOTAGE INVOLVED <br />T- <br />rnorosfDLlfiEaBU IND <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />',/j <br />�lV. <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DEBCRIPTK)NOFPROPERTYISNOVMBELOWORATTACHPWRCOPIEBI <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />Lor RLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />_ <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 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAr — <br />SIONATUREOFCONRIACTORORAUTHORIZEDAGENT( DATE <br />PINUECI ADDRESS <br />`„/ Cl� <br />APPLICANTS CITY DUSINESS LICENSE NO. ANDBUSINESSNAME <br />PLUMBING <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 />I <br />A/C—A/HNDLG UNITS—H.P. <br />I <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS—B.T.U. E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />_ <br />KITCHEN SINK f DISP <br />) <br />VENTILATION FAN <br />DISHWASHER <br />1 <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />' <br />_ <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />' <br />EXHAUSTFAN <br />_ <br />SINK (SERVICE —BAR, <br />' <br />I <br />T <br />SUBTOTAL f <br />i <br />SUBTOTAL f <br />D ' <br />PERMIT $ <br />I <br />PERMIT f <br />I <br />TOTAL FEE $1 <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR fiETBAGK <br />BIDE SETBACK <br />PLAN CHECK NLIMB[R <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />Y_ <br />BUILDING <br />-- <br />L—— <br />' <br />imwcoxlsuLowABLE <br />TYPE llrcaNSlACTUAL <br />1� <br />KawowluwMEa <br />PLUMBING <br />i <br />SIZE OF "LOG <br />NO OF SIORIFS <br />BASEMENT <br />MECHANICAL <br />SS 1 <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS REG D HEIGHT LIMITATION <br />OTHER <br />REASON FOR SP.. NKLERS <br />I <br />STATE BUILDING SURCIImE <br />I <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />