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HEATING SYSTEM:', <br />BUILDING DEPARTMENT <br />259-8810 <br />I 1 DEMOLITION <br />Li COMBINATION <br />I I )IMILDING <br />OW / <br />e <br />Mn nOOREss <br />���Aa�.1 <br />p GITY <br />z <br />TENANT <br />MAIL ADD <br />CRV� <br />ARC ITECT OR DESIGNE R <br />MAIL n DRESS <br />Zz <br />GENERAL C TRACTOR <br />MAIL ADDRESS <br />CITY <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />PLUMBING CONI RACTOR MAIL ADDRESS <br />CITY <br />GAS !J ELECTRIC U <br />MECHANICAL <br />❑ PLUMBING <br />C 1 SIGN <br />ZIP <br />PHONE <br />2K <br />�zSi-G <br />ZIP—��—�-� <br />PIICNE <br />ziP <br />41. <br />PITON <br />- <br />ZIP / <br />PHONE <br />STATE LICENSE N <br />ZIP <br />PHONE <br />STATE LICENSE II <br />ZIP PHONE STATE LICENSE IT <br />CONT TPRICE OF WORK <br />/ /.-,o .�c. <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED, <br />X( S <br />CONTACT PERSON AND PHONE NO. <br />^ / /JI�L( <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 CW AND 296.200 WAC. <br />PROP ED USE OF B DING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT f— ! BLOC OF <br />Jl---�J�7 <br />PARCEL TA%LD. NUMBER <br />CONSTRUCTION OA LENDER, ADDRESS, TELEPHONE NUMBER <br />PROJECT D RE�S <br />slcva o L <br />CITY BUSNESS LIC: NSE No <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—NHNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />/ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL <br />$ <br />SUB TOTAL S <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />FOR OFFICE IISE ONLY: <br />FRONT SETBACK <br />REAR SE;:: f <br />USE ZON9 <br />LOT AREA <br />TYPE OF LUNST. <br />NO. OF STORIES <br />:9 -t{ <br />Z <br />SI'E UI BLDG <br />FIRE SPRINKLERS RED <br />—4-.l--�" Grlti <br />OrrI.. ANCY I OAO <br />F19E ALARM HEO D <br />BY <br />PLANS <br />DATE <br />SIDE SETBACK <br />PLAN CHE KN/IAgf.b <br />FEE1e,'C90 <br />ACANT SITE <br />I -]YES C: NO <br />FEES <br />VALUATION <br />BUILDING <br />jQ ?v/ <br />BCyCgUpPN�N�CY <br />I2'3 <br />N01%PMLLNG WITS <br />PLUMBING <br />BASEMENT <br />7 YES NO <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />HEIGHT LIMITATION <br />g <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />D <br />