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APPLICATIOL FOR CONSTRUCTI46. .411 PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT 46t7r <br />3UILDINGDEPARTMEN ""' I" "- <br />?59.8810 �J JL� �v.2� ✓• �% l ��s a ° ✓2/J% .sew r/'91 <br />7 DEMOLITION ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING SIGN <br />AV MAIL /.ODRESS CITY ZIP PHONE <br />ON �SN /205 5� EvE� ' /h4L� ,iv 69A� r IAA 9 Mg �zz - 099/ <br />ENANT MAIL ADDRESS CITY 21P PHON <br />BEN LGI l2oS 4E Ey�ErrM9u (riyt-fiWR•981ox G12 -099/ <br />,RCHIECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />iENERALC Z;RAJ6N <br />1.1/.;DIRESS p) <br />CITY <br />�-2-61 . <br />ZIP <br />AlDtl0 �. /Da4 <br />PHONE <br />9miz-y/yc cy3c5- <br />IECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />SPATE LICENSE <br />'LUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />CONTRACT PP,RICE OF W <br />,ORK <br />DESCDIBE WORK j D SQUARE FOOTAGE INVOLVED <br />NsrhL�il) ILLUMINRIEnLE12elZSL�TON <br />CONT T PERSON )5XP PHONE NO. <br />N Nl• GARYL �rs6zL2yycoti INC, <br />WAu q8.3 Lt <br />77(o- ST 3S <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 HEREIN 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 />/ <br />/0.�16/93 <br />DATE <br />'ROPOSED USE OF BUILDING <br />6W)06Qc_ <br />-EGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES( <br />.OT BLOCK OF <br />PARCEL TAN I.D. NUMBER <br />:ONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NI MGER <br />TROJECT ADD <br />2.0 S, �:verelrrWY <br />CsroSESONSEM1O <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 />A/C-AFHNDLG 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 />?— <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />; <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />T— <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />; <br />ROOF DRAINS-RAINLEADERS <br />I <br />EXHAUST FAN <br />; <br />SINK (SERVICE -BAR, ETC.) <br />; <br />- <br />I <br />I <br />T <br />I <br />I <br />�— <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />°flONT SETBACK <br />REAR SET K <br />SIDE SETBACK <br />PLAN CHE NU BEfl <br />FEE <br />"i0, y <br />RECEIPT NO. <br />Z& <br />io <br />9a <br />5 <br />9aL"' <br />_ <br />REZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />/� - <br />❑ YES ❑ NO <br />BUILDING <br />_ <br />/Q- 3 <br />TYPE OF CONST. <br />NO. OF STORIES <br />OCCUPANCY <br />NO.OFDWE¢INGmufS <br />'RDEP <br />PLUMBING <br />SIZE OF BLDG. <br />FIRE SPRINKLERS REO'D <br />BASEMENT <br />MECHANICAL <br />i <br />❑ YES ❑ NO <br />— <br />ADDITIONAL PLAN CHECK <br />.TCCUPANCY LOAD <br />FIRE ALARM REOD <br />HEIGHT LIMITATION <br />OTHER <br />iEASON <br />STATE BUILDING SURCHARGE <br />NTAKE BY <br />PLANS APPROVED BY CITY OF EVERET( <br />PUBLIC WORKS <br />JM LOCAL SALES <br />DATE ID Z I ia3 �- TAX CODE IS 3105 <br />TOTAL <br />