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I <br />A <br />U <br />APPLICATIIE..i FOR CONSTRUCI.ON PERMIT <br />CITY OF EVERETT E BUILDING DIVISION <br />3200 CEDAR STREET E EVERETT, WA 98201 E259-8810 <br />1 I TTFM(L ITIFVJ I I rOMRINATION I I BUILDING MECHANICAL PLUMBING SIGN <br />DROJECT ADDRESS <br />WNEn <br />MAII ADDRESS <br />,.- _ CITY <br />ZIP <br />— _ PHONE <br />TENANT �. IAAILADLNIESS cII♦ •" """' <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENEGALCONTPACTOR MMLADDRESS _ - CITY _ uZIP_ _ — PHONE STATE LICENSE e <br />PLUMBIN� ACTOR MAILADDRESS CITY ZIP PHONE STATE LICENSEE <br />CONTRACT Pill cEUF K <br />HEATING SYSTEM: []GAS f I ELECTRIC n <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <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 />OF UILDINo <br />,PROPOSEDUSE <br />y <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACHTWOOORES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />Lot BLOCK of <br />UTHC-R 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 R :W AND 296.200 WAC. <br />.?ARCELTAKID. NUMBER <br />�iDATE <br />CONSTRUCTON LOAN LENDER. ADORERS. TELEPHONE NUMBER <br />X DATE <br />NATURE <br />CITY BUSINESS I ENSE NO, <br />PLUMBING <br />FEE <br />MECHANICAL - <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />' <br />WATER CLOSET (TOILET) <br />I <br />AIC—AMNDLG UNITS — H.P. <br />' <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />' <br />' <br />UNIT HEATERS —B.T.U. M <br />SHOWER <br />' <br />i <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />' <br />DISHWASHER <br />I <br />VENTILATION FAN <br />I <br />LAUNDRY TRAY <br />; <br />RANGE HOOD _ <br />' <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />- <br />' <br />WOOD STOVE <br />URINAL <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOL) BURNING) <br />FLOOR DRAIN <br />_ <br />; <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />SINK (SERVICE —BAR. ETC.) <br />OAS RANGE <br />I <br />' <br />GAS PIPING <br />�— <br />EXHAUSTFAN <br />' <br />I <br />1 <br />I <br />I <br />1 <br />� <br />I <br />SUB TOTAL $ <br />SUB TOTAL S <br />' <br />PERMIT S <br />' <br />PERMIT $ <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK I PF.An SETBACK <br />U9E ZONE <br />HEIGHT LIMITATION I ININIOF <br />TS DWELUND <br />NO OF <br />SIDE <br />VACANT SITE <br />n YES Tl NO <br />SIZE OF BLDGIT I <br />DYES n NO <br />CITY OF EVERETT <br />LICAL SALES <br />TAX CODE IS 3105 <br />NUMBER FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />OTIIEP <br />STATE BUILDING SURCHARGE <br />PURL IC WORKS <br />TOTAL <br />