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0 <br />n <br />APPLICATIC J FOR CONSTRUCT_ JN PERMLT `1 <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />259.8810 <br />I. ; DEMOLITION COMBINATION i� BUILDING I I MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS GIN ZIP PHONE <br />o L * 1�3102 � .uago <br />TENANITY P_ 47 of33 <br />_MIL-4 MX� -7�C6_L 42UQr`'7 Ep1,4zFEbelQ7203 <br />ARC.HITEICTOR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />/ CITY ZIP PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />ZIP PHONE <br />STATE LICENSFt <br />'%_rQ/C Pa,v r�eµc si.✓ F- /� fib <br />_ y -rE-.G ,nc SW <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />STATE LICENSE <br />T,(J.C�COTcf�i�t PG <br />CLASS OF WORK <br />I i NEW I I ADDITION <br />><ALTERATION <br />REPAIR DEMOLITION WOODSTOVE/FRPL INSERT <br />i I BUILDING RELOCATION <br />CONTRACT PRICE OF WORK I52D <br />CONTACT PERSON ANDP <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />/NStEA li �LY►SS 1�RR @ 14S .d (Svjoe'I <br />PROPOSED USE OF BUILDIN'G,�w v <br />(p%I e _ T <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 OI7 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 Ah6.200 AC. <br />X <br />LEGAL DESCRIPTION OF PROPERTY)SHaWN BELOW OR ATTACHFWRCOPIESI <br />LOT —+-- BLOCK 1 OF FI%Ca"� - <br />L <br />PRO URFSS �� n / �•, <br />7& 6 5 CE/El�l/ V <br />A MIT <br />ClIY M15M LCEHS[,A <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 />_ <br />_ <br />LAVATORY (WASH BASIN) <br />_ <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />/ I <br />KITCHEN SINK 6 DISP <br />VENTILATION FAN <br />DISHWASHER <br />, <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHESWASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT <br />; <br />FLOOR DRAIN <br />I <br />HEAT PUMP <br />I <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL S <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $1 <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FR777BACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE / t <br />RECEIPT NO. <br />USEZONE <br />h I <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />S i 00 <br />TYPE OF CONTS. ALLOWABLE <br />TYPE IXCONSI ACTUAL=Ulm, <br />Go" <br />WU,UMUMU'ulE <br />PLUMBING <br />SIZE OFF��B�LLD��G��,/G <br />w 6~15- <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PUN CHECK <br />i <br />OCCUPANCYLOAD RE 6PRNKLERSREOD PEIGHTLIMiTQION <br />REASON FDA SPRINKLERS <br />SPRINKLER <br />i <br />STATEBUILDINGSURCHARGE <br />— <br />;Szj <br />INTAKEBY <br />PLANS APPROVED BY <br />5 J <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />