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APPLICAT1koN FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 5200 CEDAR STREET E EVERETT, WA 98201 •259-8810 <br /> DEMOLITION COMBINATION I I BUILDING I I MECHANICAL PLUMBING SIGN <br /> PROJECT ADDRESS <br /> OwAl 1�T MAII.ADODESS CITY IIP I`IOfR <br /> hj101J �i/1���Psar/ /Sf�i! z9'"Au SE /!)-// Creek/ 9X0/_1- 314 - ff-24i ----- <br /> TEN?NT MAIL ADDRESS CITY ZIP PIK)NE <br /> ARCHITECT OR DESIGNER MAII ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR ,M/ML ADDRES CITY ZIP PHONE SSTATE LICENSE E <br /> -SUN c�A,S I- dl}A MC Z mG.r Af4f jr4,!nJSJ W <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSEE <br /> PIUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE UCENSE0 <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM: 1-1 GAS ❑ELECTRIC Cl <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO. <br /> I HEREBv CERTIFY THAT I HAVE READ ANO 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 WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH TWO CORES( NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT_�BLOCK <br /> OF <br /> PI t q ESj4 ,. 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 MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAXI D.NUMBER CONTRACTORS,LAW 18.27 RCW AND 290.200 WAC. / <br /> CONSTRUCTION LOAN LENDER.ADORESS,TELEM40NE NUMBER X <br /> SIGN <br /> AT E DATE <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) I A/C—AMNDLG UNITS—H.P. <br /> y BATHTUB / FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) I HEAT PUMP I <br /> SHOWER ' UNIT HEATERS—B.T.U. M ' <br /> I KITCHEN SINK&DISP ) CLOTHES DRYERS I <br /> I DISHWASHER ' VENTILATION FAN ' <br /> LAUNDRY TRAY ; RANGE HOOD <br /> CLOTHES WASHER I WATER HEATER ' <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN ) METAL FIREPLACE(WOOD BURNING) I <br /> / FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS GAS FIREPLACE i <br /> SINK(SERVICE—BAR,ETC.) I GAS RANGE ' <br /> ' 3 OAS PIPING <br /> I z EXHAUST FANLl <br /> ' <br /> I ' <br /> I ' <br /> SUB TOTAL S ' SUB TOTAL S ' <br /> PERMIT S I PERMIT S I <br /> TOTAL FEE $ TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONTS / REAR SETBACK / SIDE SETBAC OITLAN CHECK NU B R FEE RECEIPT NO. <br /> use zoN6%j/f ) LOT An p VACANT SITE EES VALUATION FEE <br /> fC / GSi nYE n NO BUILDING <br /> S� <br /> HEIGHT Uyl1►Tlpy NO OF DWELLING SIZEOF%DGITI <br /> <—<;;; UNITS 1117. S,F- LIVINL� PLUMBING <br /> 5. . GABA <br /> OCCUPANCY I NO OL SIORES OCGUPANTLOAC BASEMENT MECHANICAL <br /> GROD <br /> 0 �_I nres No <br /> FIRE ALARM REO'0 REASON ADDITIONAL PLAN CHECK <br /> OTHER <br /> FIRE SPRINKLER REDO REASON <br /> STALE BUILDING SURCHARGE <br /> TYPE OF CONST PLANS APPR VEO BY CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES <br /> T_u DATL TAX CODE IS 3105 TOTAL <br />