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APPLICATIM FOR CONSTRUCTON PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />( HEATING SYSTEM 7 GAS ❑ELECTRIC ❑ <br />JILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION El COMBINATION CI BUILDING ■MECHANICAL ❑PLUMBING El SIGN <br />MAIL ADDPE5S CITY ZIP PHONE <br />OWNER . <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITV <br />ST.- S.W. <br />ZIP <br />surtc ray <br />PHONE <br />Nc1NTilitE THE wn.4Lio43 <br />cDA A4?4AA 8-- <br />M 1Nc <br />�roo8 21CoT� <br />ZIP <br />PHONE STATE LICENSEa <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />975 LYNy4m <br />WA. <br />98046-0475 7a4-3821 <br />C�NSiROCTION AssOGW <br />5 <br />PC, Box <br />) <br />ZIP <br />PHONE STATE IICENSEa <br />MECHANICAL CONTRAC10A <br />MAIL ADDRESS <br />CITV <br />s oPtF1/�RD TAL�A, <br />WA. 984fe6 z9zPHOE3 SrwlraFS <br />gY11-yH Am &eQb" <br />4Qcl <br />CITY <br />ZIP <br />PHONE STATE LICENSEa <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />S F' <br />CONTACT PERSpN AND PHONE NA9 / <br />O <br />IN�T{Vl Fqza PROTLc�WN <br />j&21W <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />&\lulerl Im A NEW <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 />REThIL SU LD <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />r'�L DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIESI <br />OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />BLOCK <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 />PARCEL TAX I.D. NUMBER <br />s ^ 9., <br />CONSTRUCTION LOAN LENDEH. ADDRESS. TELEPHONE NUMBER <br />51GrlAT E DATE <br />psi <br />PROJECT <br />ADDRESS <br />NO <br />15's <br />S EVif1�� �L. AY <br />MECHANICAL <br />MECHANICAL <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NOTYPE OF EQUIPMENT <br />. <br />FEE <br />' <br />N0. <br />A/C-AIHNDLG UNITS-H.P. <br />' <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />UNIT HEATERS-B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />' <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />' <br />� <br />' <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />' <br />' <br />' <br />' <br />, <br />BACKFLOW PREVENTERS <br />' <br />ROOF DRAINS-RAINLEADERS <br />' <br />EXHAUST FAN <br />SINK (SERVICE -BAR, ETC.) <br />' <br />, <br />SUB TOTAL $ <br />! <br />SUET <br />$ <br />PERMIT $ <br />' <br />' <br />PERMIT <br />$ <br />TAL FEE $ <br />TOTALFEE <br />$ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK HEAR SETBACK <br />,ci cvnucI LOTAREA <br />IYPEOFCONST. <br />OF BLDG. I FIRE SPRINKLERS RED'D <br />LOAD <br />REASON <br />INTAKE BV <br />SIDE SETBACK <br />PLAN CHECK UMBER/7 <br />FEY/ <br />(IU,(( jVALUAT <br />VACANT SITE <br />❑ YES ❑ NO <br />FE/�E/SUn( <br />BUILDING <br />PLUMBING <br />a.�,l <br />"wp <br />r10. OF MLLIIIGUNITS <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING URCHARGE <br />BASEMENT <br />F1 YES ❑ NO <br />HEIGHT LIMITATION <br />PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS <br />/j /YN ll- I LOCAL SALES <br />DATE 1 _ 0-1.55 TAX CIZE IS 3105 TOTAL <br />, <br />r <br />i <br />