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BUILDING DEPARTMENT <br />259-8810 <br />ATIC'1 FOR'CONSTRUCT'IN PERM T <br />TO BE COMPLETED IN BLACK :AK —PLEASE PRINT <br />HEATING SYSTEM: A GAS 3d ELECTRIC ❑ <br />❑ DEMOLITION ❑ COMBINATION <br />OWNER MAIL ADDRESS <br />❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />CITY ZIP PHONE <br />TENANT <br />(-<A"*,q-e.w, <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE It <br />ATTCmITECTOR DESIGNER <br />MAILADDRESS <br />CITY ZIP <br />PHONE <br />kwr. <br />y..m-twA <br />P,e <br />Al� <br />GENERALCONTRACOIIADDRESS <br />ITV ZIP <br />PHONE STATE LICENSEY <br />M HANICALCON ACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE STATE LICFNSEI <br />PLUMBING CONTRAC-OR MAIL ADDRESS CITY ZIP PHONE STAP' 1-16rNSE Y <br />SrArl= vurr_%II, IRA @5ov.25194 d2iluToo 9906-& af)7 //ll :,vw-r 6~G/H/GrI <br />CONTRACT PRICE OF'NO <br />_ <br />DESCRIBE WORK AND SOUARE FOOTAG INVOLVED a <br />of <br />�v. <br />Vt0 QIl0b4GuwAi <br />CONTACT PERSON AND PHONE NO. h <br />�i 7 _$ <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 />NOI . 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 />WHICH <br />APPLICAOTIONISIS RMADET ANDP IE COMPLY WITOH KT ER STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />-3� •�i_, <br />PROPOSED USE OF BUILDING <br />g( efly_�D.eQf..r <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT BLOCK OF <br />!!// II <br />All w,/ <br />bfP ELTAX I.D. NUMBER <br />94,0_54Oil-I-0/O.� <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />fopyrlw—.3 <br />PROJECTADDRESS <br />%, �✓ <br />/ Glti' <br />sroN Y- O <br />CRY SWE SOBENSENW <br />PLUMBING <br />MECHANICAL a. `.a: <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />'TYPE OF EOUIPMENT <br />FEE _ <br />WATER CLOSET (TOILET) <br />I <br />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />VATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHCkER <br />CLOTHES DRYERS <br />KITCHE INK &QjSP <br />; <br />VENTILATION FAN <br />; <br />DISHWASHN IN <br />RANGE HOOD <br />' <br />LAUNDRY TRA <br />WATER HEATER <br />' <br />CLOTHES WASH E <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />FIREF LACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />' <br />I <br />I <br />I <br />SUB TOTAL <br />$ <br />SUB TOTAL $ <br />' <br />PERMIT <br />$ <br />PERMIT $ <br />TOTALFEE <br />$ <br />' <br />TOTAL FEE $ <br />FOR OFFICE USd0NLY: <br />.p <br />9 $D2. 4z <br />FRONT SETBACK <br />rv' <br />REAR SETBACK <br />u I <br />SIDE SETBACK <br />T <br />PLAN CHECKNUMBER <br />FEE <br />-75&, 9 <br />RE PTNO. <br />D3 <br />USEZONE <br />C-1 <br />I. LOT A/R]EA�y�� <br />{ �1 7W S <br />VACANT SITE <br />'YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />2Z6 <br />I <br />i <br />TYPE Bf CBNSi. <br />V - N <br />NO. STORIES <br />/ <br />K�Fc"P cY <br />Yq P <br />No of O IL INGUNITS <br />SIZE CI' BLDG. <br />7 A 1 <br />FIRE SF INKLERS RE O' <br />�i z wj' <br />B EMENT <br />0N <br />❑YES NO <br />MECHANICAL <br />' <br />' <br />ADDITIONAL PLAN CHECK <br />_ <br />OCCUPANCY LOAD <br />US <br />FIRE ALARM REO'D <br />HEIGHT LIMITATION <br />' <br />OTHER <br />REASON flYJ 0(edf4 Y[/FS 11W <br />17Y 090, aN/"rxr ,To <br />, <br />¢ <br />STATE BUILDING SURCHARGE <br />i-- <br />�n <br />INTAKE BY PLANS PPROVED BY <br />N <br />DATE 5 _ i I _ S) <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />. 1a� ; S, <br />