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APPLICAT16.4 FOR CONSTRUCPT.JN PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT �*w <br />l <br />BUILDING DEPARTMENT HEATINGSYSTEM: ❑GAS ❑ELECTRIC ❑ <br />259-8810 <br />DEMOLITION I COMBINATION N(BUILDING ❑MECHANICAL IJ PLUMBING CI SIGN <br />ONMER MALL ADDRESS CRY LP PHONE <br />F162ETT ML- L I402 S.E. u-mia`T h1pU- wWl r--vam wL 111M C"(p�)�4S• 11$l0 <br />TENANT MAIL <br />-Lot. <br />MAIL <br />MAIL <br />PLUMBIIIOCORMACTOR MAIL ADDRESS CITY OF PHONE STATE LICENSE <br />I NEW I I ADDITION ALTERATION REPAIR ! I DEMOLITION I I WDODSTOVEIFRPLINSERT I i BUILDINGRELOCATION <br />CONTRACT PRK:E OF WORK L•• l�D <br />TACT PERSON AND PIRC04EE NO. yp[, q <br />Ni 1•l. 1-l.K f.P �I,I 00-1- IgCID <br />D VAMNANO A FOOUGEI EO <br />�Iilc P1ab!-1�' i'('Ld, vi5c Alm unmwe, <br />LboaAm <br />PROPOSEDUSEOPBUNOIUG <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 />CONTRACTOR'S LAW 18.27 ROW AND 296.200 WAC. q <br />LEGALDEWRIPTa'MPROPERNIS11OWNBELONORARACHFWRCOPIESI <br />LOT BLOCK OF <br />PROJECTADDP[$3 <br />a ,!5 J All GU <br />T E OZSo1O 1 <br />OWIA <br />MAAISLK NAIAO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />1 <br />A/C—AMNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.TU. M E.A <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK& DISP <br />i <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />' <br />CLOTHESWASHER <br />WOOD STOVE <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 />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />�— <br />SINK (SERVICE —BAR, ETC.) <br />' <br />1 <br />SUBTOTAL S <br />SUBTOTAL. $ <br />PERMIT S <br />PERMIT $ <br />TOTAL FEE S <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FNONf SETBACK <br />REAR SETBACK <br />BIDE SETBACK <br />PLAN U BER <br />s <br />FEE <br />Avg, as <br />RECE <br />use ZONE <br />LGTAREA <br />VACANTSRE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />2 <br />2 -- <br />IYPEBiEHIi$.NLBIYANE <br />TYPE EF LON$I. MIWL <br />OdM.IMI wwmM "WTL <br />�) <br />Z� <br />PLUMBING <br />'si�Z}EN/D1FBLW. 110.OFSIOIIIES BASEMENT <br />OCCURAN YLOAO FINESPR y/�LERSRE00 HEIGHT�ATgN <br />WA 1tV9I <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />REASONFORSPRINKLEM ^ <br />avegin% Y/16(,- 81404*- <br />STATE BUILDING SURCHARGE <br />' C <br />BFMKE BY <br />PLANSAPPROVEDBY <br />CITY OF EVERETT <br />PUBUCWGRKS <br />JM 614115 <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />2 <br />