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i <br /> APPLICATIGA FOR CONSTRUCThJN PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVF_RETT, WA 98201 •259-8810 <br /> ❑ DEMOLI i(:1N ❑ COMBINATION I�.BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECT ' DRESS: L If(AJ <br /> 7OYMER MAILAMf)rss city IIP PHONE <br /> U <br /> ✓1),( i .1 e // <br /> TENANT MMI MKKR SS ('AIY IIP PHONE <br /> AFICHITECTOn DESIGNER MAII ADDRESS CITY IIP PHONF <br /> _ 1)Is 41 <br /> GENERAL CONTRACTOR MAIL ADOnEss CITY i r PHONE SIAIE LICENSE I <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY IIP PHONE STATE LICENSE <br /> PLUMBING C(WPAC.IOn MAIL ADORESS CITY IIP PHONE STATE L ICENSEI <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM: I'�GAS El ELECTRIC ❑ <br /> DESCRIBE WORK AND SOUAnE FOOTAGE INVOLVED CONTACT Pr RSON 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 /> PROPOSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHFTHEn SPECIFIED HEREIN OR <br /> LEGAL DE7IB701N OF PnOPERTY AA"ACH TWO COPIES) NOT. THE GRANTING OF A PERMIT DOCS NOT PRESUME TO GIVE <br /> LOT BLOCK _Or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> yy OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> l�/ 101 - e Aj V PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION )S MADE AND 1 COMPLY WITH THE STATE <br /> PARCEL TAM TD.NUMBER CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. / <br /> CONSTRUCRLMN LOAN LENDER,ADDRESS.TELEPHONE NUMBER X -t— O "(/ /,9 L� <br /> 51 A nE DATE <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> --r <br /> WATER CLOSET(TOILET) A/C—AMNOL6 UNITS ' <br /> ,Z BATHTUB I FORCED AIR SYSTEMS ; <br /> LAVATORY(WASH BASIN) HEAT PUMP �— <br /> SHOWER ' UNIT HEATERS <br /> I KITCHEN SINK 6 DISP / CLOTHES DRYERS <br /> / DISHWASHER I I RANGE HOOD <br /> _ LAUNDRY TRAY / WATER HEATER _T <br /> —1— CLOTHES WASHER _ WOOD STOVE <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT(WOOD BURNING) _ ) <br /> _ FLOOR DRAIN GAS FIREPLACE <br /> ' ' <br /> BACKFLOW PREVENTERS , GAS WA GE <br /> SINK(SERVICE—BAR,ETC.) GAS PIPING <br /> EXHAUST FAN <br /> I <br /> I ' <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT $ <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SFiBACK / SIDE SETBACK PI AN rurCK NIIM-� FIf RFCFIPI MO <br /> ,O 7� 'k <br /> USE ZONE �/ TOY AREA VACANT SHE FEES VALUATION FEE Cl� <br /> .L DYES ❑ No Bun DING p <br /> HEIGHT LIMITATIO NO OF DWELLI SIZE Or BIDGRI <br /> ON 17'/ S,r L/vdaG �' PHIMRING <br /> OCCUPANCY W OF StMES OCCUPANT LOAD BASEMENT MECHANICAL <br /> OR <br /> DYES --- -- --- - <br /> ADDnIONAL IY AN CHr CA i <br /> FIR SPRINKLER nEO'O of ASOTN <br /> 01r1FR ' <br /> TIRE ALARM RFO'D RIF A<DN — <br /> -- <br /> STMEF'+JILDIFIGSIInCHARGE --- —_ <br /> TYPE GF CONST PL ANS ArrnOVFW CITYOFEVERETT <br /> �M- LOCAL SALES --; (`-- <br /> -/J DAIL 51 /j9 4� TAX CODE IS 3105 TOTAL <br />