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APPLICATIPY FOR CONSTRUCT"ON PERMIT <br />CITY OF EERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-801 U <br />❑ DEMOLITION ❑ COMBINATION /Rr BUILDING Dd MECHANICAL ® PLUMBING ❑ SIGN <br />PROJECT ADDRESS:_ l82 0 %Z n d P 1. S lc- . <br />(3rcr� /�[[ cr /820 72n 1 P/. S Everest 9P203 wart i 3S J - 7�(o(a Et7ara <br />TENANT MAIL AnOnESS CITY ZIP PIIONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS DItY ZRr PHONE <br />PLUMBWGCGNTRACIGR MAIL ADDRESS Cltr HIP PHONE STATE LICENSE <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: P<GAS ❑ ELECTRIC ❑ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PRONE NO / <br />�*vb4.1- re 12 a- <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 />CONT TORS LAW 18,27 RCW AND 296.200 WAC. <br />X 3 1D -y 7 <br />PROPOSED USE OF BUILDING <br />F-� <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW HTWOCOMESI <br />LOT BLOCK Or <br />PARCEL TAX 10, NUMBER <br />Sli9-L960-0o3 - 00 <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />SKiNATURE f DATE <br />CITY BUSINESS LICENSE NO <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 />A/C-AMNDLG UNITS <br />' <br />BATHTUB <br />FORCED AIR SYSTEMS <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />SHOWER <br />' <br />UNIT HEATERS <br />' <br />KITCHEN SINK A OISP <br />) <br />CLOTHES DRYERS <br />' <br />I <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />_ <br />WATER HEATER <br />; <br />CLOTHES WASHER <br />I WOOD STOVE <br />I <br />URINAL <br />' <br />METAL FIREPLACE (WOOD CURNING) <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />I <br />BACKFLOW PREVENTERS <br />; <br />GAS RANGE <br />; <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS PIPING <br />I <br />Ld ti <br />EX14AUSTFAN <br />I <br />I <br />� <br />I <br />SUB TOTAL S <br />' <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />PERMIT S <br />I <br />TOTALFEE S <br />' <br />TOTALFEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CIIECX NU401� <br />f[`n; <br />of CrIPT NO <br />^G(_J <br />�S <br />USE <br />LOTAREAVACANT <br />Slit`/T,F`EEES <br />VALUATION <br />FEE <br />- <br />/ s J 7 <br />DY[s T <br />�- <br />_ <br />v <br />nutOWn <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE Or BLIIOnI <br />1'111MnRNG— <br />UNITS141 I <br />r <br />SPA <br />OC�CUUPANCY NO 01 STORES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />G <br />- I <br />❑YES m 'Na <br />ADDITIONAI MAN CIIf CK <br />FIRE SPRINKLER REGO <br />nFASON <br />OTHER <br />FIRE ALARM REO'D <br />REASON <br />STATE 011II DINn SIIOCIHAOOE <br />I <br />rrPEorrt.vsr <br />PLANS errnov[Ger <br />CITY OFEVERETT <br />runncwGatrines <br />Y <br />I <br />LOCAL SALES <br />'— <br />TOTAL <br />— <br />I <br />�7 <br />DATE c7 7 <br />TAX CODE IS 3105 <br />