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APPLICATIb^i1 FOR CONSTRUC'i-vbN PERMIT <br />everett <br />MP Evarpreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK —PLEASE PRINT <br />259.8810 <br />❑ DEMOLITION I I COMBINATION I I BUILDING I )MECHANICAL I) PLUMBING SIGN <br />lER MAIL ADDRESS CITY ZIP PHONE <br />D 2sra 7J -4 eve"t-e �JII A <br />WZ r LT SS-6 os'Y <br />TLENNrydi1 MAX ADDRESS CITY 21P� PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CON TRACTOR MAILADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAX ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />CLASS OF WORK <br />( I ITION M ALTERATION I I REPAIR 11 DEMOLITION 1 I WOODSTOVEIFRPLINSERT Cl BUILDING RELOCATION <br />Ll NEW ADD <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK: Yr�OO <br />DESCRIBE WORK AND SOUARE roOiTADE INVOLVED <br />1+ rt4 /1 CnS <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PPOPOSEDUSEOF13UI ONG <br />S ldbORATIACH <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTIONOF PROPERTYjsL "UBEI FOURCOPIESi <br />BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT <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', HE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE Fi ATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATUREOFCONTRACTOR OR AUTHORIZED AGENT DATE <br />PROJECT ADDRESS <br />CITY BUSINESS LICENSE NO. AND BUSINESS NAME <br />- JFSIL S'ZAPPLICANTS <br />Q <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (rOILET) <br />! <br />A/C—A/HNDLG UNITS—H.P. <br />' <br />' <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />I <br />CLOTHES DRYERS <br />' <br />SHOWER <br />_ <br />KITCHEN SINK & DISP <br />' <br />I <br />VENTILATION FAN <br />l <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />METAL FIREPLACE 6 CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT <br />I <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />' <br />_ <br />BACKFLOW PREVENTERS <br />I <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />' <br />, <br />I <br />' <br />I <br />' <br />SUB TOTAL <br />$ <br />I <br />' <br />SUBTOTAL $ <br />15; <br />PERMIT <br />S <br />! <br />PERMIT $ <br />/ ) <br />TOTAL FEE <br />$ <br />' <br />TOTAL FEE $ <br />' <br />FRONT SETBACK <br />REAR SETBACK <br />BIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />' <br />I I YES 1-1 NO <br />TYPE OF CONST ALLOWABLE <br />TYPE OF CON 1. ACTUAL <br />'P'"K� <br />6A0u <br />'pa�1141p 1X11'I <br />' <br />PLUMBING <br />1 <br />SIZE OF BLDG, <br />NO, OF STORIES <br />BASEMENT <br />MECHANICAL <br />1 1 YES II NO <br />OTHER <br />, <br />' <br />OCCUPANCY LOAD FIRE SPRINKLERS RECD <br />HEIGHT LIARTATION <br />I J YES 1.1 NO <br />I STATE BUILDING SURCHARGE <br />i <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />' <br />' <br />APPLICATIONACC BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />