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APPLICATIC`� FOR CONSTRUCT�N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> ��rr <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC 1�, - I �-s-�. I <br /> 259-8810 <br /> DEMOLITION COMBiNQTION BUILDING MECHANICAL <br /> OWNER MAILA��RE55 Z'P � � PLUMBING ' � I SIGN <br /> CITY PHONE <br /> �r�ei n� IzTin F3-aE��,f�r- �I IfJ t�Iz�-l--ri 7sn �I-3q - 5�i89 <br /> MAI�AODRESS CITV <br /> '{']_ � �� i IIP I ' � PMONE <br /> � L I 'P i n q � ��-P�1-�1 (X�. <br /> H��R MAIL A� ESS CITV <br /> '/ 2I1P PHONE <br /> GENERALCONTRACTOR , NqILA�����. I I������L` ^ ���r�'�I (-{ {��.��22�wr�� <br /> CITY ZIP PHONE STqTE LICENSE 4� <br /> MECNANICALCONTRACTOR iNqILADORE55 CITV <br /> Z��' PHONE S7ATELICENSEq <br /> PLUMBINGWNTRACTCR IAAILF�ORE55 CIiY <br /> Z�P PHONE STATE IICENS[b <br /> CLASS OF WORK — <br /> � IkNEW !. I ADDITION ! �. ALTERATION . '�. REPAIR � DE:MOLITION ��. ��. WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PEFSON AND PHONE NO. <br /> CONTRACT PRICE OF WORK I_� Q , Qr ��.,'f�� /y�� <br /> DESCniBE WORK qND SOUAqE FOOT4GE INVOLVED n a I 2 wal l siGllC 77 u^r —�I l..l 1 <br /> 3 h�an LLmen-� s i s �'8� ea. E cl i re°cl�,'ona s <br /> PRGPOSEO USE OF BUILOING <br /> i HEREBY CFRTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ���n�-� �ra��- � L����_ APFLICATION AND KNOW THE SAME TO BE TRUE AND COqRECT.ALL <br /> �EGAL�ESCRIPTI Of PRpp�pTY�S 0 VN�ELOW pq qTTACH FOUR COPI[S) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �oT e�ocn oF 4VORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> S�e �-,,�,�P ^� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> U OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I qM AUTHORIZED BY THE <br /> OWMER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT CTOR:;LAW 18.27 RCW AND 296.200 WAC. <br /> PP0.)ECT�7A�ORESS [7.� <br /> I I IL �` 'l J r`�1 _J � � sir.rvnruHc anrc ZL <br /> V <br /> PLUMBING cirvous�rvess ice �rvn -- <br /> MECH CAL <br /> NO. TYPE OF FIXTURE OR ITEM �FEE T_ Np, TYPE OF E�I�IPMENT FEE <br /> WATER CLOSET(TOILET) AiC-NHNDLG UNITS-hI.P. <br /> BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. I <br /> LAVATORY(WqSH BASIN) ' UNIT HEATERS-B.T.U. H <br /> SHOWER � CLOTHES DRYERS T-- <br /> KITCHEN SINK&DISP VENTILATION FAN , <br /> DISHWASHER I RANGE HOOD --�--- <br /> LAUNDRYTRAY ' WATERHEATER - <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT <br /> FLOOR DFiAIN HEAT PJMP � <br /> BACKFLOW PREVENTERS GAS PIPINC <br /> ROOF CRAINS-RAINLEADERS � EXHAUS i-FAN <br /> SINK(SERVICE-BAR,ETC.) � - -- <br /> ' � <br /> SUB TOTAL $ SUB TOTAL 9 <br /> PERMIT g � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FqONT5ET0A R[qRS[Tp�CK SIOESETpACK � <br /> l�__ P�AfI IEO�U�ER F��- � qEC[I�NO <br /> �_�___ __ J_ _" 3 0 <br /> USE ZONE l0T AREn „ VqCANT SRE FEES � <br /> c - ( 5���^1 C+ A� �� VALUATION 'EE <br /> 1YVEOfCONIS.AILOWABLE iYEOfLOqSTaLiUAL BUILDING —i�d <br /> aC�oqqpy NOO�DWRUryGONrtS <br /> LPOLc <br /> awn�oir�� ; <br /> SREOFBLDG. NO.OFSTOPIES BASEM1IENT <br /> M1IECHANICAL <br /> OCCUPANCVLOAD FIRESPRNNLERSREO'� NEIGHTLIMIiATION ADDITION.4lPLANCHECK i <br /> �/�� SPRINKLCR <br /> REASON FOR SPRINKLERS i <br /> STATE BUILDING SURCHARGE i JO <br /> INTAKE BY PlANS APPROVED UV CITY OF EVERETT <br /> LOCAL SALES "�suc woaks ,.� <br /> cf� ( Iq��� TAX CODE IS 3105 TOTAL � <br />