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APPLICATIC ` FOR CONSTRUCT' IN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT 407r <br />HEATING SYSTEM" <br />BUILDING DEPARTMENT J GAS J ELECTRIC J <br />259-8810-- <br />DEMOL!TION COMBINATION 84ILDING MECHANICAL PLUMBING SIGN <br />oNER Mar gDDaEss/� N0 j71V ci—v ')>'Dtil�9'�TX <br />wPHONE u. — <br />Al 1 <br />TENANT �rxL�- qD- O ((-. TR V�- k- LL.�l/v{1 PHONE •n/ <br />�.A.Q-1 1 - � H*f7Mgi DDR � l) l�CC�G� W/ / CCL�IL�L.- 1 PNONE �-f.L <br />PRd <br />'ENE CONTRA^�CLTnnOR11 MAIL ADDRESS CITY ZIP PHONE STATE LICENSE/ <br />MECFANICAL CONTRACTOR <br />MALL ADDRESS <br />CRY <br />ZIP <br />PHONE <br />STATE LICENSER <br />PLUMBING CONTRACT OR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE/ <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. n`r^�.y�pr 'S-� <br />) <br />F0HA <br />5APJ6? SHIM f?II - 8J()dT) <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <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 COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT 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 />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 />PROPOSED USE OF BUILD IN <br />%�`�-�� <br />LEGAL DE RIPTION OF PROPS (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />— <br />PARCEL TAXI 0 NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMBER <br />PRE ADDRESS��A C'M`�� C ' ,n <br />55GN.TUPc—I:.—Tr <br />CTYPUSI11C55LICENSI Np <br />PLUMBING _ <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) _ <br />A/C—A/HNDLG UNITS—H. P. <br />BATHTUB _ <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />i <br />UNIT HEATERS—B.T.U. M <br />SHOWER _ <br />CLOTHES DRYERS <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />�— <br />_ <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />I <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST "AN <br />_ <br />SINK (SERVICE —BAR. ETC.) <br />I <br />T <br />I <br />_ <br />SUB TO fAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />PERMIT $ <br />i <br />TOTAL FEE $ <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CH J NUMBEfy7 <br />FEE �� <br />REC�� ,.,5 /7 <br />OFEE O/ <br />USE ZOIIE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />r) <br />❑ YES NO <br />BUILDING <br />TY DF <br />NO. OF STORIES <br />;Cuzr <br />MI Of OWELll11G UNrt5 <br />—AI <br />Ant <br />1 <br />PLUMBING <br />SIZE OF BLDG <br />FIRE SPRINKLERS REC'D <br />BASEMENT <br />MECHANICAL <br />,ay <br />AJO <br />❑ YES ❑ NO <br />— <br />OCCUPANCY LOAD <br />FIRE ALARM REO'D <br />HEIGHT L Z TATION <br />ADDITIONAL PLAN CHECK <br />d <br />D <br />OTHER <br />' <br />REASON <br />STA TE BUILDING SURF.HARGE <br />�— <br />v <br />INTAKE BY <br />PLANS A ROVED BY <br />� <br />CITY OF EVERETT <br />PUBLIC WORKS <br />S <br />/ <br />LOCAL SALES <br />DATE j p _ 11 _9 y <br />TAX CODE IS 3105 <br />TOTAL <br />& kc- 30, au <br />