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�. ,�1 <br />APPLICATION FOR CONSTRUCTION PERMIT <br />�f <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />n DEMOLITION Fl COMBINATION n allILDING n MECHANICAL Il PLUMBING SIGN <br />PROJECT ADDRESS a n3� <br />GENERAI CONTRACICR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSET <br />ME`N-I'CA_L CONTRACTOP <br />M'DRE55 /�,//� <br />L <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />'1J�tX r <br />�Y� „2i <br />PLUMBING CONTRACTOT. <br />MA ADE LESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE• <br />CONTRACT PRICE OF WORK <br />HEATING SYSTEM: I I GAS I 1 ELECTRIC rl <br />DESCRIBE WORK ANO SCUARE FOOTAGF INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO RE TRUE AND CORRECT ALL <br />PROVISIONS 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. TH. iT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I CC' -IMPLY WITH THE STATE <br />CONTRACTORS,/ LAWS 18.2277 RCWAN/DD 296 200 WAC. � <br />'( " Z /j/l��E�l.�tl l.Xl- /"J <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />Lrn BLOCK OF <br />PARCEL TAX I D. NUMBER <br />CONSTRUCTIONLOANIENDER. ADDRESS. TFIEPHONENUMRFR <br />SIGN RE OAIf <br />CITY BUSINESS LICE NSC NO <br />PLUMBING <br />MECHANICAL _ <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />_ <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/HNDLG UNITS -H.P. <br />�- <br />_ <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS - B.T.U. M E.A. <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS - B.T.U. M <br />_ <br />KITCHEN SINK & DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />VENTILATION FAN <br />LAUNDRY TRAY <br />RANGE HOOD <br />CLOTHES WASHER <br />WATER HEATER <br />T <br />URINAL <br />WOOD STOVE <br />_ <br />DRINKING FOUNTAIN <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />FLOOR DRAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />_ <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />; <br />SINK (SERVICE -BAP. ETC.) <br />GAS RANGE <br />_ <br />GAS PIPING <br />EXHAUSTFAN <br />T <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />_ <br />TOTALFEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: i / <br />FRONT SFTRACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CITE NUMBER <br />FFF <br />C O. <br />USE ZONE <br />IOT AREA <br />VACANT SITE <br />FEE <br />VALUATION <br />FEE <br />BUILDING <br />i <br />i <br />AYES fl NO <br />IIEIGIIT LIMITATION <br />NO OF DWELLING <br />SIZE OF BLDGR.1 <br />I <br />UNITS <br />PLUMBING <br />OC('UPANCY NO Of STORIES <br />OCCUPANT LOAD <br />BASEMENT <br />MECHANICAL <br />GROUP <br />I <br />, <br />T1YE5 It NO <br />ADDITIONAL PLAN CHECK <br />--- <br />I <br />FIRE. ALARM REDD <br />REASON <br />OTHER �[ ti <br />yp I (i'CJ <br />FIRF SPRINKLER RED <br />REASON <br />I <br />STATE BUILD) G SURCHARGE <br />TYPE OF CONST <br />PLAN P PROVED BY <br />CITY OF EVERETT <br />PRBUf, WORKS <br />I/1-_` <br />LOCAL SALES <br />p -f <br />TAX CODE IS 3105 <br />TOTAL <br />I <br />AT J • <br />