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APPLICATIC 1 FOR CONSTRUCT )N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ZbAS ❑ ELECTRIC ❑ <br />259.8810 <br />❑ DEMOLITION LI COMBINATION ❑ BUILDING P4ECHANICAL LI PLUMBING SIGN <br />Lnc61 M q U�o S? Sad ' c"q <br />�TENANT MAIL ADDRESS <br />CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGEINVOLVED <br />CONTACT PERSON AND PHONE NO <br />L <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 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 A I COMPLY WITH THE STATE <br />CONTRALTO W 1 ND 296.200 WAC. <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIESI <br />LOT— BLOCK of <br />PARCEL TAX LD NUMBER I..r <br />CONSTRUCTION LOAN LENOEH. AADDRESS, TELEPHONE NUMBER <br />PROJECT AD RES9 -7 r <br />saxeruAF DAYS <br />C1118L messtcExsL xD <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />, <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />I ' <br />SHOWER <br />' <br />CLOTHES DRYERS <br />I <br />KITCHEN SINK & DISP <br />i <br />VENTILATION FAN <br />' <br />I <br />DISHWASHER <br />RANGE HOOD <br />WATER HEATER <br />I <br />LAUNDRY TRAY <br />_� <br />; <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />I <br />SINK (SERVICE —BAR, ETC.) <br />_ <br />SUB TOTAL $ <br />SUB TOTAL $ <br />' <br />PERMIT $ <br />' <br />PERMIT $ <br />I <br />TOTAL FEE $ <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />; <br />TYPE OF CONST <br />NO OF STORIES <br />Ottur�Mr <br />trar <br />NUgpVLUINtuKls <br />PLUMBING <br />I <br />I <br />SUE OF BLDG <br />FIRE SPRINKLERS REGO <br />BASEMENT <br />YES r-, NO <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD <br />FIRE ALARM REO'D <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />—T <br />INTAKE BY <br />PLANS APPROVED BY <br />DATE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />A <br />