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APPLICATIC FOR CONSTRUCT'"N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT I HEATING SYSTEM: j4GAS ❑ ELECTRIC J _ <br />259-8810 <br />I.1 DEMOLITION 1 1 COMBINATION kic BUILDING 7 MECHANICAL L I PLUMBING SIGN <br />OWNER MAILADDRESS (206) 4663952 CITY ZIP PHONE <br />Wash. Technology Educ Assoc.Foundation - S. Porter, J. Estep, TrusteesBox 972, LaConner, WA <br />TENANT MAIL ADDRESS CITY ZIP PHONE 98257 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />Dept of Tech, WWU, Bellingham, WA 98225 650-3380 <br />GPNERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE. <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br />CONTRACT PRICE OF WORK <br />r <br />DESCRIBE WORK AND SOUAF2 FOOTAGE INVOLVED <br />2061 sq ft. <br />CONTACT PERSON AND PHONE NO. <br />Jamps ... Dzake. Vasracip HS 699-8077 <br />0R. s./ -EX_ 4 --3 <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 HEREII:'OR <br />NOT. 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 />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 />X <br />PROPOSED USE OF BUILDING <br />Residen-``-i31 Resale <br />LEGAL DESCRIPTION OF PROPERTY ISHO'NN BELOW OR ATTACH TWO COPIES) <br />LOTZS-- BLpact-of Ppchonwpnd <br />Volume 30, p 75-76, Snohomish County <br />-- <br />PARCEL TAX LD NUMBER <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />�AbDRESS <br />�p�dy� <br />P OJR ECT <br />g, <br />4901 Fowler/)Everett, WA <br />scwAru - oar <br />CITY BUiINLssl cNSE Np <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 />AIC—AIHNOLG UNITS—H.P. <br />BATHTUB / <br />FORCED AIR SYSTEMS—B.T.U. M E.A. - <br />- <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />_ <br />SHOWER / <br />CLOTHESDRYERS _ <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />/ <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />/ <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />; <br />GAS PIF NG <br />_ <br />ROOF DRAINS—RAINLEADERS <br />EXHAUS I' FAN <br />SINK (SERVICE —BAR. ETC.) <br />4.5 - L L Lc <br />' <br />I <br />SUB TOTAL S <br />SUB TOTAL $ <br />— <br />PERMIT S <br />- <br />PERMIT $ <br />TOTAL FEE S <br />TOTAL FEE S <br />FnC nCC'ICC I ICP nN1 V. <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETSAFK <br />PLAN CHECK NUMBER <br />FEE <br />� <br />RECEIPT NO. <br />?AD� <br />�� <br />b� <br />�,15 <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />❑ YES ❑ NO <br />NO. OF STORIES <br />rr'S <br />TYPE OF LONST. <br />attuoaxcY <br />PLUMBING <br />SIIZZE BoDGsF <br />_X' <br />FIRE SPRIr.KLERS REO'D <br />BASEMENT <br />�O <br />MECHANICAL <br />sn 1 <br />S' 4RA¢,c <br />J <br />❑ YES <br />ADDI IONAL PLAN CHECK <br />i <br />OCCUPANCY LOAD FIRE ALARM REDD HEIGHT LIMITATION <br />OTHER <br />�( 0 Z <br />REASON <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />J M <br />CITY"EVERETT <br />SALES <br />PUBLIC WORKS <br />TOTAL <br />DATE c} Ci �c� <br />LOCAL <br />TAX CODE IS 3105 <br />