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b everett <br />.ON olll% <br />APPLICATION wi'OR CONSTRUCTIO ,d PERMIT <br />the EYeg,"n TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett EATING SYSTEM: IJ GAS I, ELECTRIC U <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING )( MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY � n ZIP PHONE <br />5Ot9INCi SLX°Po� S Q\AC,LS ?0 3701 51r19�TLC rvA %12.4 <br />TENANT MAIL ADDRESS CITY 71P PHONE <br />ARCHITECT OR DESIGNER <br />ZIP PHONE <br />GENERAL CONTRACTOR <br />IT1'IORtWON <br />MAIL ADDRESS <br />-Po IM <br />CITY ZIP <br />WA �SXq <br />PHONE LICENSE <br />LIS1-1305 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE) <br />MILAWW4 <br />F0 2ys,Z7 <br />5C/tTCLE AJA 9$12y <br />7(12.3311 At9IA1IV0.972A)0 <br />CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />PHONE <br />LICtNS[ <br />CLASS OF WORK <br />NEW � ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />�,�0 ` <br />CONTRACT PRICE, OF WORK ✓E�/E�ll�' <br />CONTACTI�PEpR�S-OLN�AND P`H1ONE NO <br />"•",1 "� ��z�l, <br />DESCRIBE WORK AND SCIATIC FOOTAGE IrVOLVED <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 296.20U WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />AOPPO,TSED USE OF UmL�c <br />+� ce.,Q1 QIFIGE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK OF <br />_ <br />Soo 3, not � RaL.n" � -;o _ L,(� <br />TPLUMIHNO F+7 <br />APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <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—AHNDLG UNITS—H.P. <br />� <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-- BTU. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE $ CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />_ <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />' <br />T <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />_ <br />SINK (SERVICE —BAR, ETC.) <br />7 <br />-lpCIhII WZIdTZ <br />� <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTALFEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SLTBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />S e <br />1,b5 ! <br />L 2_ <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPE OF CONTS ALI OWABLE <br />TYPE OF CONST ACTUAL <br />CCLUPANO <br />NO Ml VAR) W,14 T5 <br />s"�° <br />PLUMBING <br />SIZE OF BLDG <br />140 OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD FIRE SPRNKLERS RF.O'D HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />' <br />1. <br />LOCAL SALES <br />05PR"VED <br />Fh <br />TAX CODE IS 3105 <br />TOTAL <br />J <br />