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ti <br />APPLICATIG, FOR CONSTRUCT. 'N PERMIT F <br />It, Env911ron TO BE COMPLETED IN INK —PLEASE PRINT <br />r ry of <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />HEATING SYSTEM: D GAS O ELECTRIC Ll <br />DEMOLITION <br />. COMBINATION <br />BUILDING 2&MECHANICAL <br />PLUMBING SIGN <br />OWNER MAIL ADDRESS <br />sor-IN H/67k SAY ASSMIRLY <br />:ITY <br />Xpli <br />ZIP <br />E✓E�tF1T.u/r4»oN�B�/ <br />PHONE <br />Z244"o <br />CITY <br />ARCIUTECTOADESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />AUSnN CoPlpANY <br />MAIL ADDRESS <br />/0/S-47* A✓E <br />CITY <br />6; v�r"W4• <br />ZIP <br />1920► <br />PHONE <br />166•Koo <br />LICENSE <br />ZZ3-01-0-ST-1e7M <br />MECHANICAL CONTRACTOR <br />COSIo f/kb MW?F6-MN <br />MAIL ADDRESS <br />/0*0 /17TsT <br />CITY ZIP PHONE <br />Aif ORK(AAV rMi 9yo9J 8Z7-%W,+ <br />LICENSE <br />CoSCOM1010- <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />lZr—.. I I .I ...TInfJ RGRAIR nFMOI ITION WOODSTOVE/FRPL INSERT L; BUILDING RELOCATION <br />01N.`•• __ _ _ - IR <br />CONTACTPERSON Ka AND PI1E NO <br />Z _qe. S <br />CONTRACT PRICE OF WORK A PRiNk[. <br />" <br />DESCRIBE WORK AND SOUARE FOOTAGE INIFOLVED <br />lu6 SPK�Nac K,e eN<s 41 / <br />2 <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 />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT_ BLOCK OF <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 296.200 WAC. <br />SIGNATURE OF CONTRACTOR ORAUT14ORIZED AGENT DATE / 'JO -Q7- <br />X g � FAFAWS074W 10o24-/G 14 <br />PROJECT ADDRESS <br />--- APPLICANTS CITY BUSINESS LN;I:NSF. NO ANO tl'J>I VESB NAME <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS —BTU. 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 />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />; <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />GAS PIPING <br />�. <br />BACKFLOW PREVENTZRS <br />RGOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />:E- <br />S <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REARSETBACK <br />USEZONE <br />LOT AREA <br />TYPE Of CONIS ALLOWABLE <br />TYPE Of CONST ACTUAL <br />SIZE OF BLDG <br />NO OF STORIES <br />OCCUPANCY LOAD <br />FIRE SPRNKLERS RE <br />BY <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />3 <br />FEE <br />RECEIPT NO <br />VACANT SRE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />amPAxc. <br />Na aownurc u"m <br />-- <br />PLUMBING <br />BASEMENT <br />MECHANICAL <br />I <br />ADDITIONAL PLAN CHECK <br />HEIGHT LIMITATION <br />76 ; Sf <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />y 7G Sa <br />