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APPLICATIr"V FOR CONSTRUCT"ON PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: '4GAS U ELECTRIC U _ <br />259.8810 <br />[l DEMOLITION F.] COMBINATION 1"1 BUILDING [f7 ',IR <br />L �`[yMo)0ECHANICAL II PLUMBING I I SIGN <br />MAIL .• ONME J� As I 'd s PHONE <br />ist- F 1 SF flicf 'k <br />- ^-•• <br />�n nwn... <br />CITY <br />ZIP <br />PHONE <br />ARCHITECTORDESIGNER <br />MAR ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAR ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE F <br />MECHANICAL CONTRAC IGH <br />G/rz�lwocL•Padfdh/c <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />Il430' <br />MAIL ADDRESS <br />CITY <br />skLtar'AeUE ktEk6eA <br />CITY <br />ZIP <br />0/963y <br />ZIP <br />PHONE <br />-4•-2rz3yySY <br />PHONE <br />STATE LICENSE <br />GRL-E�pull �-sEo <br />STATE LICENSE <br />1:UR1 HAGI PHX:E a YTOIA� 3 9 70 , <br />PlD , <br />DF4,;RIBE WWOORRP�AND 3A ARE FOOTAGE INVOLVED CONTACT PERSON AND PyD NE <br />ZnSFLOD 7C_nrD Q-n. RnN_ du.._ _CY/ Od v. fIU CFI <br />9�P� �O%.r CortAac do io Q %s�' <br />tJ r <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRVAND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 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 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 />CONTRACTORS LAW 16.27 RCW AND 296.200 WAC. <br />�f /9 <br />PROPOSED USE of BUILDING <br />• Sr <br />LFGAL DESCRIPTION OF PROPEHTY (SHOWN BELOW OR A' TACH IWO COPIESI <br />LOT- BLOCK OF <br />PARCELTAXID. NUMBER <br />6glt _ own OI q _ <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />PROJECT ADDRESS L <br />6KNIAIUIE/(�( <br />city nUSnR°°IflliR4 rxi <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />I <br />A/C—A/HNDLG UNITS—H.P. <br />, <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U75M E.A. <br />LAVATORY (WASH BASIN) <br />, <br />UNIT HEATERS—B.T.U. M <br />; <br />SHOWER <br />' <br />CLOTHES DRYERS <br />I <br />KITCHEN SINK 8 UISP <br />VENTILATION FAN <br />' <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />T <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT <br />; <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />, <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />�— <br />EXHAUST FAN <br />; <br />SINK (SERVICE —BAR, ETC.) <br />- <br />SUB TOTAL $ <br />', <br />SUB TOTAL $ <br />PERMIT $1 <br />PERMIT $ <br />— <br />TOTAL FEE $ 1 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />3�b1� <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />C1 YES C7 NO <br />BUILDING <br />' <br />TYPE OF CONST <br />NO OF STORIES <br />DR:uwAcr <br />K° n PATu,MG WnF <br />PLUMBING <br />' <br />0R0U° <br />CIZE OF BLDG. <br />FIRE SPRINKLERS REDID <br />BASEMENT <br />MECHANICAL <br />' <br />71 YES 1-1 NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM RED <br />HEIGHT LIMITATION <br />OTHER <br />i <br />' <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OFEVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />