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H <br />0 <br />H <br />z <br />o� <br />CPS <br />H H <br />O rA <br />�CA <br />APPLICATIO#FOR CONSTRUCTIDN PERMIT' <br />TO BE CPLETED IN BLACK INK —PLEASE PRIN F <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259-8810 <br />I i DEMOLITION I I COMBINATION I BUILDING MECHANICAL 1 PLUMBING SIGN <br />OWNER MAILADJRESS CITY ZIP PHONE <br />LL,TInev l� tr.�r11G� NS>6 Fedar.+l 6,,e�cT� qua � -za''ss' '�3'I1 <br />TENANT MAIL %DDRESS CITY ZIP PHONE <br />.1 ei (K•I V1Ev k4Cp <br />1J <br />ARCHITECT OR DESIGNER <br />MAIL AODR,Eµ$.S <br />CITY <br />ZIP <br />PHONE <br />I/ LL l j QM (JLL I <br />JI &3N 1 LN <br />GE RALCONTRACTOR <br />�0fi¢ �aErS <br />MAIL ADDRE <br />Z+y <br />CITY <br />nLv q)• <br />ZIP <br />EveJett ItSn3 <br />PHONE <br />353-.-331 <br />STATE LICENSE <br />501,2Eto�_IQ <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />Pilch cl& J'l u. ibl;+ eD ►3cA <br />S')-g <br />CITY <br />rA <br />ZIP <br />rsV;gSj]o <br />PHONE <br />STATE LICENSE <br />ISY m <br />CLASS OF WORK <br />I I NRw I I AnnITTnN <br />IV. ALTERATION <br />1 I REPAIR <br />I I DEMOLITION i I WOODSTOVE/FRPL INSERT <br />; 1 BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO. <br />vY <br />CONTRACT PRICE OF WORN D D ^ <br />GE O DESCRIBE WORK AND SOUARE FOOTALVED 1L <br />7eln �o <br />Qr-O walk ✓Few W, lrL ,,i c- <br />60 5 <br />3' <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ ND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />Dy S PnL ✓ <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGALDESCRIPTION OFP PERTY(SHOWN BELOW OR ATTACH FOUR COPIES) <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OFF 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 VHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />x <br />PROJECT AOD/PESS <br />510 ATu oL,-i C (3 (' -3 OME <br />SYL FtAAY� Mli <br />CITY GU5WESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <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 />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS - <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />_ <br />WOOD STOVE <br />URINAL <br />_ <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />-- <br />SUBTOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />OQ <br />PERMIT $ <br />i <br />TOTAL FEE $ <br />TOTAL FEE $ <br />. <br />13sT iTd3T91:fflL938lIIw9 <br />FRONT SETBACK <br />REAR SETbACK <br />SIDE SETBACK <br />PLAN CHECK _NUMBER <br />FEE <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE _ <br />BUILDING <br />- <br />TYPE OF CONTS. ALLOWABLE <br />TYPE OF CONST ACTUAL <br />Impm.Y <br />cxaP <br />I NO 9 MELLING GNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />' <br />ADDITIONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD FIRE SPRNKLERS REO'0 HEIGHT LIMITATION <br />SPRINKLER <br />I <br />_ <br />REASON FOR SPRINKLERS <br />STATE BUILDING SURCHARGE <br />i <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />� <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />— <br />