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APPLICATION FOR CONSTRUCTION PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, VIA 98201 •259-8810 <br />1 DEMOLITION F l COMBINATION I I BUILDING 1 MECHANICAL l PLUMBING X'SSIGI <br />PROJECT ADDRESS 3oS S•� El/f2E7e ffWld-22� <br />WNER MAIL ADDRE SS CITY ZIP PHONE <br />Hwwt Toiknl toe. Ilf4 3j7 hyf. AF710 Wrn* 99I01 f>12-3/00 <br />TENANT MMLADDnESS CITY 71P PHONE <br />MNWS 6O4nRt w1F9Q 30S S.E. E-Vf*7rOWL k*' Yt1III, y / 3-24M/ <br />llr <br />GENERAL CONTRACTOR MAILADDHESS CITY 711` PHONE STATE IICENSE0 <br />Ah"8/1 1. 591V ON l25'5 b✓OUtg AID: Al, 5EAffi6 fg]Pcl -7Q7-.ft7nA ✓A4rsvc:r07 AV. <br />MAILADDRF.SS CITY 71P PHONE STATE LICENSE . <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STAIE I ICENSE. <br />CONTRACT PRICE OF WORK a <br />1500 L <br />HEATING SYSTEM: I I GAS I l ELECTRIC 11 <br />DESCRIBE WORK pNO SOUR FOOTAGE INVOLVED <br />AF iw►sflYlt 043r06 IiWroIAftL) IMML S16n1 <br />CONTACT PERSON AND PHONE NO <br />✓r Z In! �2g2-0700 <br />7b I✓fiJ 7r*" r <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION 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 />APPLICA ION IS/MADE AND I COMPLY WITH THE STATE <br />CONT TDRS W 1B CW AND 296.200 WAC. <br />X -I <br />PROPOSED USE OF BUILDING <br />�E�ML CoeIME�tIA�y <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK of <br />PARCEL TAX I.D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />SIGN E DATE <br />n r'- T I ,/ <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />' <br />_TYPE <br />A'C—A/HNDI.G UNITS —H.P. <br />BATHTUB <br />FORCED AIR'iYSTENIS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />1 <br />HEAT PUMP <br />I <br />SHOWER <br />' <br />UNIT HEATERS — B.T.U. M_ <br />KITCHEN SINK 8 DISP <br />i <br />CLOTHES DRYERS <br />DISHWASHER <br />' <br />_ <br />VENTILATION FAN <br />1 <br />LAUNDRY TRAY <br />; <br />RANGE HOOD <br />' <br />CLOTHES WASHER <br />1 <br />WATER HEATER <br />URINAL <br />' <br />WOOD STOVE <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />I FIREPLACE INSERT (WOOD BURNING) <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS FIREPLACE <br />; <br />SINK (SERVICE — BAR, ETC.) <br />GAS RANGE <br />GAS PIPING <br />_ <br />i <br />EXHAUSTFAN <br />i <br />1 <br />I <br />SUB TOTAL $ <br />; <br />SUB TOTAL S <br />; <br />PERMIT 5 <br />PERMIT $ <br />1 <br />_ <br />TOTAL FEE S <br />' <br />TOTAL FEE S <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />HEAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FBF Z <br />RECEIPT NO <br />us-`EGZOZIE / <br />IOTAPEA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />I1 YES I NO <br />DunnwG <br />5 <br />I <br />I <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDG/TI <br />UNITS <br />PLUMBING. <br />I <br />OCCUPANCY <br />NO 01 SIPPoE$ <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL. <br />GnOUP <br />1 <br />I <br />I IYF$ II NO <br />ADDITIONAL PLAN CHECK <br />- <br />T <br />FINEALARMREOD <br />REASON <br />OTHER <br />I <br />FIRE SPHINKI Fr, PEQ D <br />REASON <br />STAIE BUILDING SIIHGInnG,E <br />I <br />TYPE OF CONST <br />rIANSAPgn0VFDRY <br />CITY OF EVERETT <br />PUBLIC WOnKS <br />�(L/� <br />LOCAL SALES <br />TOTAL <br />—_— <br />--`— <br />OptE Z �% <br />TAX CODE IS 3105 <br />ri <br />