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IL <br /> APPLICATIOiII FOR CONSTRUCTION PERMIT <br /> IwT`n•Il <br /> TRS Eve <br /> CITY OFF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> " DEMOLITION COMBINATION A BUILDING MECHANICAL >( PLUMBING SIGN <br /> OWNER MAIL ADDRESS STY ZIP PHONE <br /> NANi MAIL ADDkfEgS CITY ZIP PHONE <br /> C ARCHITECT OR DESIGNER MAR.ADDRESS CRY 21P PHONE i <br /> H 0ENERAL CONTRACTMA0.ADDRESS CRY 21P PHONE LICENSE 6 <br /> CONTRACTOR I <br /> K ice► C� L1fhs�Glmn� Ka17� E'f/ 7l WL3 34fsv� r2e>�l,t _Isycr <br /> MECHANICALCONTRACTOR MAR ADORE59 CRY ZIP PHONE LICENSES <br /> '�N IIl�yyy JIn -- <br /> L MBING CONTRACTOR WXADDRESS CITY ZIP PHONE LICENSES <br /> z A1,911) 1 1 <br /> CLASS OF YORK <br /> [�0 H C �, NEW f 1 ADDITION ALTE ATION ❑ REPAIR J DEMOLITION ❑ WOODSTOVE/FRPL INSERT i J BUILDING RELOCATION <br /> ^� � TENANT IMPFIG EMEWORMTERIOR REMODEL ONLY CONTACT PERSON AND PHONE NO <br /> n. c) <br /> H CONTRACT PRICE OF WORK: <br /> H <br /> DESCRIBE WORK AND SQUARE F TAGS INVOLVED <br /> Hy U Sit <br /> Cyy PRO^OSEDUMOFBUILDI I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> O H 1, QD a / APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> fD PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION O PROPERTY ISHOW'N BELOW OR ATTACH FOUR COPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ,' H3 M LOT_ BLOCK OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> 1`3O En L - AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> M- OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE j <br /> „�/, OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> OR lA APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br /> SIGNATURE Cf CONTRACTOR OR AUTHORIZED AGENT DATE <br /> PRWECTA^^'E pC 'c <br /> APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <br /> /x/17_ 4LJ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) '- AIG-AIHNDLG UNITS-H.P. Il <br /> BATHTUB 0 ' FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) rI - UNIT HEATERS-B.T.U. M i <br /> SHOWER CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP - VENTILATION FAN ' <br /> DISHWASHER RANGE HOODlaw ' I" <br /> LAUNDRY TRAY ; WATER HEATER ' pggg <br /> 1 ' CLOTHES WASHER WOOD STOVE <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY 30 ' <br /> e <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> _ FLOOR DRAIN HEAT PUMP ' <br /> 1 ' BACKFLOW PREVENTERS I GAS PIPING ' C <br /> ROOF DRAINS-RAINLEADERS ' EXHAUST FAN ' <br /> SINK(SERVICE-BAR,ETC.) of <br /> Illir 74 <br /> I <br /> SUB TOTAL $ ; - SUB TOTAL S ' J <br /> ,_jam PERMIT S PERMIT S <br /> TOTAL FEE S I TOTAL FEE $ <br /> FRONT SETBACK REAR 6E17fACN SIDE BE PLAN CHECK MUMMA F�_,o RECETBTj),) <br /> E ZdF T �` Y.��(L// . 1 <br /> USE ZOA LOT AREA VACANT SITE FEES VALUATION FEE <br /> 1� 1 3 420 YES ' ' NO BUILDING $ 3$ p I <br /> IYPEOF COMET ALLOWABLE TYPE OF CORS ACTUAL BIxIKAYn I womuNcimis , <br /> S i PLUMBING 0 :00 <br /> SIZE P NO.OF STORIES BASEMENT MECHANICAL ' 00 <br /> u�b t d I ❑ YES [X NO <br /> OCCUPANCY LOAD FIRE SPRNKLERS REGO HEIGHT LIMITATION OTHER i7 <br /> YES pC NO ZBF STATE BUILDING SURCHARGE <br /> REASON FOR SPRINKLERS <br /> STATE ENERGY SURCHARGE <br /> APPLICATIJNACC BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS ,Q.') <br /> LOCAL SALES C.90 <br /> 8� TAX CODE IS 3105 TOTAL <br /> 9%Pvy/f - i3as r <br />