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APPLICATI .� FOR CONSTRUC7.ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET•EVERETT, WA 98201 9259-8810 mm <br /> I1 DEMOLITION I 1 COMBINATIONAA I I BUILDING I1 MECHANICAL PLUMBING SIGN <br /> PROJECT ADDRESS 30-7 g0 tEA PILAcdc' SI GUI FV&-9E-7'Tl u)A <br /> OWNER r.LA.I......Ai.. � MLAL AeDDRES"4PHO. <br /> TK <br /> /1JA¢ <br /> TENANT MAIN ADDRESS C TY ZIP PI10NF <br /> ARCHITECT OR DESIGNER MAI ADDRI SS CITY 71P 144ONF <br /> GENERAL CONTRACTOR MALADDRESS CITY ZIP PHONE STATE LICENSE <br /> 45� A 13&Wt 1+Cr e o7-r C s <br /> MECHANICAL CONTRACTOR MAIL AOnRESS CITY ZIP PHONE STATE LICENSE i <br /> PLUMBING CONTRACTOR MAL ADDRESS CITY ZIP PHONE STATE LICENSE If <br /> CONTRACT PRICE OF WORK <br /> HEATING SYSTEM: GAS fl ELECTRIC fl <br /> DESCPIBEWORK ANOSPAREF TAOE INVOLVED CONTACTI'ERSONAND PHONE.NO <br /> F S.F a< <a— a- 4�/f— 2 73 7 <br /> Z O "s- G 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 THI:TYPE OF <br /> 5 r— 2 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRIPTION OF PRO RlV SIIO BELOW OR ATTACH oCOPIE 1 NC THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT GP <br /> _ A S o Ns AUIHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> / ertrte IIA •'E I..•7 8 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> 2 2 O f_S IF / I�a77a7L�s+1�wrs 1 s Y PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> / / OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> /J 90 APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TA%I D.NUMBER /} D 7ie� s CONTRACTORS LAW 1 27 RCW AND 296.200 WAC. <br /> 3936- oco — oi8 - 0 3n A <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER <br /> SI NATURE ,I <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATER CLOSET(TOILET) ' A/C—AMNDLG UNITS—H.P. ' <br /> (_ BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) I HEAT PUMP ' <br /> SHOWER ' UNIT HEATEF:—B.T.U. M ' <br /> KITCHEN SINK 6 DISP I <br /> I CLOTHES DRYERS <br /> DISHWASHER ' VENTILATION FAN ' <br /> LAUNDRY TRAY RANGE HOOD i <br /> CLOTHES WASHER I WATER HEATER ' <br /> URINAL ' WOOD STOVE <br /> DRINKING FOUNTAIN I METAL FIREPLACE(WOOD BURNING) I <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS ; GAS FIREPLACE ) <br /> SINK(SERVICE—BAR,ETC.) I GAS RANGE ' <br /> ' GAS PIPING <br /> � E%HAUST FAN ' <br /> 1 <br /> I i <br /> I <br /> I � ' <br /> SUB TOTAL S ' SUB TOTAL $ ' <br /> PERMIT S I PERMIT $ I <br /> TOTAL FEE S ' TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> PRONT 5 REAP S TRACK SIDE SETS 'O / PLAN CHECK NUMBER FEE RECEIPT NO. <br /> OA& <br /> USE ZONE ' OTAREA P VACAN • E FEES VALATION FEE <br /> f1 YES Il NO BUILDING BQ 98 rQ <br /> HEIGHT UM <br /> NO OF DWELLING SIE 5 LDONTI 4Ivyj4.+ — <br /> 7 5jr AAAfi� PLUMBING Da <br /> OCCUPANCY NO OF STORES OCCUPANTLOAD BASEMENT � // MECHANN:AL Q Q� <br /> vE5 YNO <br /> •3 ADDITIONAL PLAN CHECK <br /> FIRE REASON <br /> OTHER <br /> R SPRINKLE.RRE '0 ASM - <br /> STATE BUILDING SURCHARGE <br /> TYPE OF CO!IST P SAPPROVEOnY ITY OF EVERETT PURI IC WORKS <br /> rl j 4 LOCAL SALES <br /> y -/�l DA 9 6 95- TAX CODE IS 3105 1 TOTAL <br />