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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF ERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259.8810 <br />f-I DEMOLITION f I COMBINATION f I BUILDING 11 MECHANICAL PLUMBING I I SIGN <br />PROJECT ADDRESS 40'5 r <br />DWNER MAIL ADOnFSS / rITY ,XJ nn rn,nur <br />-Trs5r •5, Ole,L rI, Q8AD 225 72. 1 ST Sk toll _ <br />TENANT MAIL ADDRESS CITY 71P PHONE <br />ARCHITECT OR DESIGNED MAIL ADDRESS /� CITY ZIP PHONE <br />on' 1 24A A -11 Yz � E A�, te[ g\I •p 0 <br />GENERAL CONTRACTOR MNL ADDRESS CITY ZIP PHONE STATE LICENSE <br />MSJ 004y5TPLA-c4IoAJ 515 72,,J S+ E�� z� U'409• ;m-(o se c) ri1531 p OS��Op <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br />i'ic.ChAiP 2 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />CONTR(¢T PRICE OF V 1( <br />NQ p <br />HEATING SYSTEM: I I GAS I I ELECTRIC GIB <br />DESCRIBE WORN AND SQUARE FOOTAGE INVOLVED <br />\ \ h. <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 />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 15 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LA 1B RCW AND 296.200 WAC. <br />a- <br />X <br />PROPOSED USE OF BUILDING <br />e <br />R��(2lx7ive 5 <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOWOR ATTACH TWO COPIES) <br />LOT % BLOCK <br />PARCEL TAX I D. NUMBER <br />CONSTRUCTION LOAN I.ENOER. ADDRESS. TELEPHONE NUMBER <br />SIGNATURE DATE <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL _ <br />NO. OP EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />_TYPE <br />A/C —AIHNDLG UNITS —H.P. <br />' <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS — B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />I <br />HEAT PUMP <br />H <br />SHOWER <br />' <br />UNIT HEATERS—B.T.U. M <br />' <br />KITCHEN SINK A DISP <br />I <br />CLOTHES DRYERS <br />I <br />DISHWASHER <br />1 <br />VENTILATION FAN <br />H <br />LAUNDRY TRAY <br />) <br />RANGE HOOD <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />I <br />URINAL <br />' <br />WOOD STOVE <br />' <br />DRINKING FOUNTAIN <br />I <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />FLOOR DRAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE — BAR, ETC.) <br />I <br />GAS RANGE <br />I <br />' <br />GAS PIPING <br />' <br />I <br />EXHAUSTFAN <br />I <br />I <br />1 <br />I <br />I <br />_ <br />SUB TOTAL S <br />' <br />SUB TOTAL $ <br />' <br />PERMIT S <br />I <br />PERMIT S <br />I <br />TOTAL FEE $ <br />' <br />TOTAL FEE E <br />' <br />FOR OFFICE USE ONLY. hplr I 7 <br />FRONT SFTRACN <br />?ram l <br />READ SFTBACFK <br />SIDE. SETBI�CK <br />PLANCHEC MB ' <br />FFF <br />RECFVT NO <br />USE F <br />i1 <br />IOTAREA <br />M <br />VACANT SITE <br />IIYES fYNo <br />FEES <br />VALUATIIOj/N <br />FEE <br />BUILDING <br />' f 7i <br />e <br />HEIGHT VMQATION <br />r <br />NO OF DWELLING <br />UNITS <br />SIzF Or Rl OOn1 <br />�5 f ,•LA lrlA / <br />v,✓ <br />PLUMBING <br />OCCUPANCY NO M clnnR; <br />onURg <br />OLICUPANT IOAO <br />VIA <br />BASEMEN! <br />AYES ✓O <br />MECHANICAL <br />ADDIIIONAI PANCHECK <br />TnE ALAnM nEOD <br />Ne <br />REASON -- <br />OTHER <br />rIOFSPRINKIFRnFon <br />AV <br />RFASON <br />STATE BUILDING SURCHARGE <br />F71 <br />`,?•� <br />TYPE OrCONST <br />' f <br />PLANS APPIOVEDBY <br />im <br />DATE Vlllqrj <br />CITY OFEVERETT <br />LOCAL SALES <br />I TAX CODE IS 3105 <br />POOL ICWORKS <br />TOTAL <br />[ p <br />