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APPLICATICA FOR CONSTRUCT:JN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET •EVERETT, WA 98201 • 259.0810 <br />1 I DEMOLITION COMBINATION I I BUILDING I MECHANICAL PLUMBING i SIGN <br />3ROJECT ADDRESS <br />2 C5 3i �f� � lrerPlL'T i <br />BTIER A MAIL ADDRESS CITY ZIP P14ONI' <br />TENANT <br />IA AADDRE�SSy� <br />HIP <br />PHONE <br />1f <br />ARCHITECT OR DESIGNER <br />MAIL AnCAESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE STATE LICENSE F <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />LITY <br />ZIP <br />PHONE STATE LICENSE• <br />Pl BINO CONTRACT MAIL ADDRESS CITY ZIP PHONE STATE LICENSE Ir <br />5 23- 'do 16%a aw-ign c r �soAeK <br />CONTRACT PRICE OF WOOIF- <br />( aL-G P <br />HEATING SYSTEM: f] GAS ❑ ELECTRIC n <br />DESCRIBE 1YDRK AND SQUARE FOOTAGE INVOLVFD r <br />ire 7 - 1 <br />— <br />CONTACT PERSON AND PHONE NO <br />I HERESY 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 MA D I COMPLY WITH THE STATE <br />CONTRAC 1 '27 'AND 296.200WAC. <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPE'TTY(SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT _ BLOCK DF <br />O - - - <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />SIGNATU E DATE <br />CITY BUSINESS LICENSE NO. <br />PLUMBING <br />MECHANICAL <br />NO. <br />_ <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-AMNDLO UNITS -H.P. <br />' <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />r <br />HEAT PUMP <br />I <br />SHOWER <br />' <br />UNIT HEATERS-B.T.U. M <br />; <br />KITCHEN SINK 8 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />T <br />I <br />VENTILATION FAN <br />' <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />r <br />WATER HEATER <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />i <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />SINK (SERVICE - BAR. ETC.) <br />GAS RANGE <br />GAS PIPING <br />I <br />EXHAUST FAN <br />I <br />I <br />� <br />I <br />� <br />SUBTOTAL S <br />SUB TOTAL S <br />_ <br />PERMIT S <br />I <br />PERMIT S <br />I <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SFTRICK <br />PEAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMGFR <br />FEE <br />RECEIPT NO <br />USEZONE <br />LOT AREA <br />VACANT SHE <br />n YES n NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />HEIGHT LIMITATION <br />NO. OF DWELLING <br />UNITS <br />SIZE OF SLDG/TI <br />PLUMPING <br />OCCUPANCY NO OF STORES <br />GROUP <br />OCCUPANT LOAD <br />PASEMENT <br />n YES n NO <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />FIRE ALARM REGO <br />REA&W <br />OTHER <br />FIRL SPRINKLER REDO <br />REASON <br />STATE BUILDING SURCHARGE <br />TYPE IF CONST <br />PLANS APPROVED RY CITY OF EVERETT <br />LOCAL SALES <br />DATE TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />