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` APPLICATI( '9 FOR CONSTRUC'�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />�/ o[p� �o:�s 7"�/ N`.:U✓.i� �RG.,�_ �l�d�.� '%33 - �7aU <br />BUILDING UEPARTMENT HEATING SYSTEM: � GAS U ELECTRIC ❑ —� <br />259-8810 . <br />❑ DEMOLITION ❑ �COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER IAAILAO�flE55 CITY ZIP PHONE <br />US Bank 1415 Fifth Avenue. 16th F1. Seattle WA 98101-22A� (�06) 3q4-4fif,l <br />TENAN7 MAILADDRESS CITY 21P PHONE <br />ARCHITECTORDESIGNER MAIIpDDRE55 CITY ZIP PHONE <br />JMt�T Arch�tect One Co;tmierr_e Square Suite 840 Mem�his TN 3R103 �401 ) 543-4f194 <br />GENERALCONTRACTOR MAILADDfiESS CITY ZIP PHONE STATELICENSEN <br />CONTRACTOR MAILAODRE55 <br />CITV <br />CONTRAGT PflICE OF WOflK <br />�60.000.00 <br />DESCRIBE WOFK ANO SOUARE FOOTAGE INVOLVED <br />Buildin�a 900 Sq�'t Full Service Bank <br />/ <br />inside of the ogQS _ Sugermarlcet. <br />J '�/f�='.lJn �� <br />PROPOSED USE OF BWLLiWG <br />LEGAL DESGRIPTICN OF PpOPEflTV (SHOl7N BELO:V OH AT ACu TWO COPIES) <br />LOT — BLOCK OF <br />PAFCELTAXI.�.NUME:N <br />CONSTRUCTION � f�=N LEN�ER, ADURESS. TELEPHONE NUMBER <br />�tlBff9.:;acn WR;( r�_._� - - r..a „�n <br />� . .�_ � .... .... .... .. <br />PROJECT ADDRzSS � �����// ,' ` / <br />��06 � _� [�-� _ Uu <br />PLUMBING <br />N0. TYPE OF PIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP � <br />� DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />� SINK (SERVICE—BAR, ETC.) <br />SUB TOTAL $ <br />RERMIT $ <br />� TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK PEAR SETBACK SIDE SETBACN <br />USEZONE <br />iYPE OF CONST. n � <br />�/ V <br />SIZEOFB�� T./ <br />�l�g <br />OCCUPANCYLOAD <br />� <br />REASON <br />6X�iTlN� <br />INTANE BY <br />LOT AFEA <br />NO.OF STORIES <br />� <br />FIRE SPRINKLERS REOD <br />FIFE A� RM REO'D <br />Yrs <br />�'iyJ�/�'�S <br />PLANSAP,/I;�OVEDBY <br />DATE Ir/Z9_� <br />VACANT SITE <br />❑ YES ❑ NO <br />OCCOPA�tiLY NO OiOWFL'IA6WI�i5 <br />GflWP � <br />'7 _ <br />BASEMENT <br />❑ YES �YNO <br />HEIGHT LIMITATION <br />CITY OF EUERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />LICENSE c <br />21P VNON'c STATE LICENSE p <br />CONTACT PERSON At,J PMONE NO. <br />(901) 523-3914 <br />I HEREBY CEfiTIFY THAT I HAVE READ AND EXAM�NED TF;iS <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 CON�FLETED WITH WHETHEfl SPECIFIED HEREIN OR <br />NOT. THE GRANTINC OF A PERA4IT 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 />PERFORIv1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THiS PFCIPERTY TO PEAFORM THE WORK FOR WHICH <br />APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />G <br />�iGNA IiE AiE <br />LIIY �WiNE55 LICEkSE N0. <br />MECHANICAL <br />NO. TYPE OF E�UIPMENT FEE <br />A/C—A/HNDLG UNITS—H.P. <br />I�ORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTIIES DRYERS <br />RANGE'HOOD <br />N!AlGE HEATER <br />WOOD STUVE <br />METAL FIREPLACE <br />HEAT PUMP <br />EXHAUST FAN <br />SUB TOTAL S <br />PEflMIT $ <br />� <br />PLAN CHECK <br />BUILDING G,�1 � � <br />i <br />PLUMBING i <br />MECHANICAL � <br />i <br />� <br />ADDITIONAL PLAN CHECK 29 � <br />OTHER � <br />STATE BUILDING SURCHARGE I � <br />� <br />PUBLIC WORKS ' <br />i <br />� <br />TOTAL �I; � ! <br />