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APPLICATIOd FOR ^ONSTRUCT.JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />I I DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Morse, ConsirVL{7vvt 'S41(o 1S} An S. EVE2ETf toO y'r.2c 3 7 3 / <br />TENANT MAIL ADDRESS -CITY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE t <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />W A BoTfITlCa Co 13459 <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />CITY <br />AuRo¢A AUC n/. <br />OILY <br />ZIP <br />SPSITjL&,w.9 <br />ZIP <br />PHONE <br />96133 7AV�140 <br />PHONE <br />STATE LICENSE If <br />WABOTPL42l 'lA <br />STATE LICENSE <br />CLASS OF WORK <br />'Z <br />oCDAID nFM01.ITION <br />WOODSTOVEIFRPL INSERT <br />BUILDING RELOCATION <br />NtW ,Avun vi. ........,.. .._.__- <br />I <br />CONTACT PERSON AND PHONE NO. <br />t � MM <br />o <br />CONTRACT PRICE OF WORK W <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />REC1J (k"� �i(.• U^Tor • INSYIAL,L. NEW A.G- UNIT" <br />_ --- <br />_ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSE DU EOF@WLDING <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />_ <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEG SCRIPTK)N OF PROPERTY (SHOWN BELOW OR ATTACN FOUR COPIES) <br />BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT _ <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 18.27 RCW AND 296.200 WAC. <br />7- <br />I <br />D., <br />PROJECT ADDRESS <br />�Vsf ///v£S.] <br />ClTYBUSN_SS LICFNS[ NO <br />PLULdING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />I <br />A/C—AMNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD _ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />i <br />URINAL <br />DRINKING FOUNTAIN <br />; <br />FIREPLACE INSERT <br />I <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR. ETC.) <br />I <br />T <br />SUB TOTAL $ <br />SUB TOTAL $ <br />r� ' <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTALFEE $ <br />Ire <br />run urrn c L1Jc <br />FRONT SETBACK <br />vnau. <br />REARSETDACK <br />SIDE SETBACK <br />PLAN CHECK N UFAOER <br />0?s'T �9 � l <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— <br />TYPE OF CONTS. ALLOWABLE <br />TYPE OF CONS. ACTUAL <br />DCCUUK4GY <br />GROUP <br />NO OF MELLING MTS <br />PLUMBING <br />_ <br />SIZE OF BLDG. <br />No, OF STORIES <br />BASEMENT <br />MECHANICAL <br />yrIGG <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS REO'0 HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />SPRINKLER <br />STATE: BUILDING SURCHARGE <br />PUBLIC WORKS <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAR CODE IS 3105 <br />TOTAL <br />yS' ;" <br />