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� PVBTPII <br />APPLICATIC" FOR CONSTRUCr&j"-1 PERMIT <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />vie LYPIBIPPII <br />CITY or <br />_ <br />everett r HEATING SYSTEM: L1 GAS U ELECTRIC <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS r CITY 21P PHONE <br />Tj{ c eu ., Po .Box 3?0-1 AA/S of-7C_sd n rrc e , w� 98�i�- Z� 3yz -s y7X <br />TENANT AILADDRESS CITY 2!P PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY Z.P PHONE <br />RUISTIni CU, rioter �� AVS iW, &VEo-I5Ty1A qLf Ui ( age -gnz <br />-#c 567 <br />GENERALCONTRACIOR MAIL AUVHESS CITY(� bP� PHONE LICENSE <br />�aZcw�ti . LICENSEI <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 21P P110NL LICENSE <br />CLASS OF WORK,/ <br />NEW Jc ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />J� T <br />CONTRACT PRICEOFWORN <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />VENT-TL/PrIee SA'64t/S-r Foy «G <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />aL t <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COO( 51 <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT <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 />SIGNATURE OF CONTRACTOR CA AAU.TTHH_OR12EEU AGENT DATE <br />—_ <br />�L <br />X /. /- FT/1 �1 <br />PROJECT AUDRESS gLD6 LIT O_2'IE <br />_(�—TSCIT USINEL!�"�IMi <br />APPLICANTS CITY UUSINESS LICENSE NO AND BUSINESS NAME <br />'340 W . C,+ I /LjD E✓C-t. WA • <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />NC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />BATHTUB <br />—i— <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />.T— <br />DISHWASHER <br />RANGE HOOD <br />_ <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />— <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />FOUNTAIN <br />FIREPLACE INSERT <br />_ <br />_DRINKING <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 />SUBTOTAL $ <br />SUBTOTAL S <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE S <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK REAR —SETBACK 510E 5ETBACN CHECK NUMBER LEE 2 RGCF.In` <br />/�E <br />7ONE LOT AREA VACANT SITEFEES <br />VALUATION <br />FEE <br />FMECHANICAL <br />�p <br />7 'TYPE <br />OF COMSAlLOWABIfIYPF Of LOHSI ACIUAI IX4Aur AUIYIINi1l MGumis <br />EofBUw No DF s)onlEs BASEMENT <br />APORKWAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRNKLERS REGO HEIGHT LIMITATION <br />OTHER <br />--i-- <br />— <br />STATE BUILDING SURCHARGE <br />HEASON FOR SPRINKLERS <br />PUBLIC WORKS <br />INTAKE BY PL NSAPPROVED BY CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />r 7 V OS <br />TOTAL <br />