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4 lcII FOR CONSTRUCT" IN PERMIT <br />E �o E COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTN�IENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL 'SC PLUMBING ❑ SIGN <br />ZIP YHUNI, <br />TENANT � S0 MAILADDRESS <br />L,046CuJ fJFR£A/ <br />CITY <br />Ayk �Z(/ <br />ZIP <br />�� <br />PHONE <br />�l7 \:34/ //-7 <br />70/UJ <br />ARCHITECT OR DESIGNER MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE III <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE# <br />PLUMBING CONTRACTOR MAIL ADDRESS�; <br />CITY <br />ZIP <br />PHONE <br />ATE LICENSE IF57`a4ff <br />�� e c/i. E/ <br />99. )36)X <br />2494' /i25 <br />D G <br />— ' .c C <br />CONTRACT PRICE OF WORK <br />Y <br />((�� <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING <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 BELOWOR ATTACH TWO COPIES) <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK of <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 1 COMPLY WITH THE STATE <br />PARCEL TAX I.D. NUMBER <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG. <br />.2O —b- OJc7 <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESS <br />1,21VSIGNATURE <br />OAIE <br />CITY bU51NESS LICENSE N0 <br />rn J� q`T'--�' <br />SA ) ( l6V, <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. TYPE OF FIXTURE OR ITEIv, <br />FEE <br />A/C—A/HNDLG UNITS—H.P. <br />WATER CLOSET (TOILET) <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />DISHWASHER <br />' <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />WATER HEATER <br />— <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />; <br />METAL FIREPLACE (WOOD BURNING)Jkdft <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 />SINK (SERVICE —BAR, ETC.) <br />' <br />' <br />SUB TOTAL $ <br />7 <br />SUBTOTAL $ <br />PERMIT $ <br />20 ' <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />. v.. .......� <br />FRONT SETBACK <br />�..�.. <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES C NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />' <br />TYPE OF CONST. <br />NO. OF STORIES <br />U6UPA4CY <br />DROOP <br />xo of OWEGING UNITS <br />PLUMBING <br />i <br />SIZE OF BLDG. <br />FIRE SPRINKLERS REDD <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />ADDITIONAL PLAN CHECK'' <br />OCCUPANCY LOAD <br />FIRE ALARVIREOD <br />HEIGHT LIMITATION <br />OTHER <br />E. <br />i <br />REASON <br />STATE BUILDING SURCHARGE <br />PUBLICWORKS <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />_ <br />DATE <br />LOCAL SALES <br />TAX CODE IS 3105 <br />, -- <br />TOTAL <br />