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P <br />On <br />APPLICAl JN FOR CONSTRUIL [ION PERMIT <br />I�,.r.... lu,", <br />CITY Of <br />everett <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK —PLEASE PRINT <br />259_8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL <br />OWNER M _ADDRESS —_ CITY ZIP PHONE <br />A-PE_'UMBING <br />i <br />SIGN <br />T NAN <br />MAIL ADORES' <br />CRY <br />ZIP <br />PHONE <br />ARCHRECTOR DESIGNER <br />MAIL ADDRESS <br />Cltt <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSER <br />I <br />� <br />AEC NIC CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE# <br />f <br />.................ne.w�e <br />MAA ADDRESS <br />CITY <br />21P r <br />PHONE <br />LICENSE# <br />I// i. nJ�liJi. IA���.�r����Y���i�'r/LL49—/l�'1.1/i—rr..rriirr�r�•. <br />DCOAID V"Til ITISW .IT.TDSTOVEIFRPL INSERT 11 BUILDING <br />G <br />TENANT NPR,'TENT OR INTERIOR REMODEL ONLY <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORK:— <br />DESCR'BE WORK AND SQUARE FOOTAGE INVOVEO <br />PACIPOSEDUSEMBUZ 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 />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TI IIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL ESCRIPTION of PROPERTY I$ BELOW OR ATTACH TOUR COPIES# <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRECUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FCR WHICH <br />- <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />�j(Y/ /�lC� /NG/.y���• i�J /' <br />I31 O U <br />PRDR S <br />OJ�T„ <br />/ <br />APPLICANTS CITY BUSINESS LICENSE NO ANDBUSIN SNAME f <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. I TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET( <br />.e — <br />AIC—A/HNDLG UNITS—M.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />_ <br />LAVATORY (WASH BASIN) <br />/ ' _ <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />_ <br />f <br />KITCHEN SINK 8 DISP <br />/ — <br />VENTILATION FAN <br />mot— <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER A G, r <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIM14EY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />— <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUSTFAN <br />' <br />SINK (SERVICE —BAR. ETC.) <br />' <br />SUB TOTAL <br />E <br />SUB TOTAL a <br />PERMIT <br />9 <br />PERMIT $— <br />TOTAL FEE <br />$ <br />' <br />TOTAL FEE f <br />3 d <br />FRONTSETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHEC.N NUMtlER <br />fFE <br />RFfFIPT NO <br />USE ZONE <br />LOT AREAVACANT <br />SITE <br />LEES <br />VALUATION <br />FEE <br />BUILDING <br />— <br />��— <br />YES NO <br />1TPEDCOKSTAIIONAKE <br />TYT'EOr CONST ACTUAL <br />im— <br />Ko alnnliiwumTf <br />rAm�* <br />FWMBING <br />/J <br />S�'E OF BLDO. <br />lZ OFSTOKES <br />BASEMENT <br />MECHANICAL <br />YES NO <br />OTHER <br />' <br />' <br />OCCUPANCY LOAD FIRE SPRNKLERS REDO <br />HEIGHT IIMITAt10N <br />STATE BUILDING SURCHARGE <br />' <br />I <br />YES NO <br />REASON FOP SPRNKLERS <br />STATE ENERGY SURCHARGE <br />I <br />! <br />APPUCAtION ACC. BY <br />PLANS A"PROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />/ <br />