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L*7 <br />APPLICATII A FOR CONSTRUCT ION PERMIT everett <br />rrw tivy-•�� TO BE COMPLETED IN INK -PLEASE PRINT <br />CITY OF <br />everett HEATING SYSTEM: UOAS ❑ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />' 259.8810 <br />DEMOLITION COMBINATION �BUILUING MECHANICAL PLUMBING SIGN p <br />OVVNEp-_.IA.I��J `iI DRE6S CITY tl� PHONE O i <br />irh��,7/7D/i .mil <br />MAIL ADOPE65 CITY ZIP PHONE <br />TENANT <br />ARCHITECT ON DESIGNER MAL766 ESS <br />CITY tIP PHONE <br />CITY Lp PHONE LICENSF• <br />GENERAL CONTRACTOR MAL ADDRESS <br />PHONE LICENSE• <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP <br />PLUMBING CONTRACTOR MAR ADDRESS CITY ZIP PHp:E LICENSE• <br />Vi K �.jp--__ \oe_.ID re"nI ITInm WOODSTOVEIFRPL INSERT BUILDING RELOCATIC <br />NEW ADDITION ICm-I l• iY••.•^••• <br />-- ------ <br />- <br />CONTACT PERSON AND PHONE NO <br />CONTPACT PRCE OF WORK / �2 .' Q ' <br />— <br />DE6CRIBE WONN AND 6WARE i00TAGE INVOLVED <br />�f / 11A c� <br />APbO� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />I•ROPOSEDUSE OFBUILDING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />�fQ <br />PROVISIONS OF LAWS AND ORDINANCES GOG'"9NING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />.ff.AI DEBCPiPTMN1 OF PROPERTY(SHOWN BELOW OR ATTACHFOI!P COPIES( <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <br />TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />AUTHORITY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AU'. HORIZED 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 I8.27 RCW AND 296.2DO WAC. <br />SIGNATURE OFCONTRACTOAORRAAAUrHGAIZZEE�DAAGGEfNTT �JDATE <br />I�RGJECT ADDRESS <br />APPLICANTS 6CjTY BUSINESS LICENSE N0 AND BURINESB NAME <br />PLUMBING <br />FEE <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />IVATER CLOSET (TOILET) <br />A G—A HNDLG UNITS—H.P <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />UNIT HEATERS—B.T.U. M <br />LAVAIURY(WASH BASIN) <br />' <br />CLOTHES DRYERS <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK A DISP <br />DISHWASHER <br />' <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />_ <br />URINAL <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSEIIT <br />DRINKING FOUNTAIN <br />I <br />FLOOR DRAIN <br />HEAT PUMP <br />PREVENTERS <br />; <br />OAS PIPING <br />�— <br />BACKFLOW <br />ROOF DRAINS—RAINLEADERS <br />E%HAUS FAN <br />SINK (SERVICE —BAR, ETC1 <br />I <br />_ <br />I <br />I <br />) <br />SUB TOTAL $ <br />SUB TOTAL s <br />' <br />PERMIT s <br />PERMIT f <br />' <br />TOTALFEE s <br />TOTALFEE s <br />' <br />FOP OFFIGH Ubt: <br />FRONT SETBACK <br />UnLT: <br />REARSETBACK <br />SIDE SETBACK <br />PUNCIIECK NUMPER <br />TIE RECEIPT NO <br />uSE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATIOII <br />FEE <br />BUILDING <br />— <br />PLUMBING <br />— <br />'GPEOFCONTS MLOWAFLE <br />TYPE OF WNST AE1Wl <br />am.«ar.. <br />°"d1F <br />wotrwwwuNrs <br />SqE OF SLOG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIO14AL PLAN CHECK <br />OCCUPANCY IOAO FIRE 6PRNKLERS REDO HEIGHT LWITATION <br />REASON FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />•� ) y'C <br />PUBLIC WORKS <br />INTAKE BY <br />—��OCALSALES <br />PLANS APPROVED BY <br />CITY OF EVERM <br />31 <br />TAX LOBE 133106 <br />TOTAL <br />�3-� <br />