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APPLaCAT10,'—` FOR CONSTRUCTI`N PERMIT � <br />TO BE COMPLETEQ IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC C) __ <br />259•8810 <br />I}�XDEMOLiTION � 1 COMBINATION I 1 BUILDING I_l MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILRDDRE55 CITY 21P PIIONE <br />BRCR Associates, 1429 Broadway Everett Wa. 98201 258-1414 <br />IENANT M�ILADDRE55 CITY ZIP Pf10NE <br />AFCHIfEGtOR0E51GNEN MAILRD�RE55 <br />ZIP P/IONE <br />GENERALCONTRACTOR MRILAODRE55 CITY 21P PNONE STATELICENSE� <br />Welch Enterprises, Inc. P. 0. Box 366, 115 Lind Street, Mt. Vernon, Wa. 98273 1092 <br />MECHANIC�LCONiRACTOR MMLADDRE55 CITY ZIP PIqNE STRTELICENSEI , <br />PLUMBING CONTPACTOR <br />GONTRRCT PRICE OF WORK <br />DESCRIOE WOAK AND SWARE FOOIAGE INVOLVEO <br />Everett Fire Department and then debris <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERiv ISIIOWN BELOW Ofl ATTACH TWOCOPIES� <br />LOT BLOCK OF <br />Sely Bdy St. Rd No. 1, <br />VOpCEtTAzI� NUMBEP <br />CONSTRUCiIONIDANLENDEP.�DDRE55,1ELEPHONENUMBER <br />6 4 <br />NO. � TVPE OF FIXTURE OR ITEM <br />WATER CLOSET (TUILET) <br />LAVATORY (WASH BA! <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEM <br />ROOF DRAINS—RA�NI <br />SINK 15ERVICE—BAR <br />PERMIT E <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FFONiSETB�CK RE�RSETBACK <br />USE 2ONE <br />IYFE OF CONST <br />SIZE OF OLOG. <br />OCCUPANCYLOAD <br />PEASON <br />INTANE BV <br />LOT AREA <br />FIPE SPRINNLERS HEO'U <br />PL�NS RPPAOVED AY <br />onr� <br />CITY 21P <br />lftto <br />d Bdy 150 <br />STATE LICENSE I <br />ANO PHONE NO. <br />h E. Stef <br />i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TY�E OF <br />WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE Ofl CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION Ofl THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 3Y THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br />APPLICATION IS MADE AND I CGMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />NO. TYPE OF EOUIPMENT <br />AIC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT NEATERS—B.T.U. M <br />CLOTHES DFYERS <br />VENTILATION FAN <br />� RANGEHOOD <br />; WATER HEATER <br />� WOOD STOVF <br />� METAL FIREPLACE I <br />; FIREPLACE INSERT <br />� HEAT PUMP <br />; GAS PIPING <br />� EXHAUSTFAN <br />� <br />VAC4N7 SIIE <br />❑ YES ❑ NO <br />oaw�xcr Hoaovrtuixcuxns <br />GRWO <br />BASEMENT <br />❑ YES ❑ NO <br />CITY OF E <br />LOCAL: <br />TAX CODE <br />J� <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADD�TIONAL PLAN CHECK <br />OTIIER <br />STATE BUILOING SURCH�RGE <br />PUOLIC WORKS � <br />TOtAL <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />�q <br />A <br />� <br />d <br />y- � <br />