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Qi�PLICATIC 1 FOR CONSTR�.ICT��N REIQMIi �� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />BUILDING DEPARTMENT ���ATING SYSTEM: ❑ GAS �] ELECTRIC � � <br />259-8810 <br />': DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBiNG SIGN <br />OWNE6 MAILAO�RESS CITY ZIP PHONE <br />� � <br />iftPN��.�{<.SC'G L�il�'(Ci���i.,�" �-I"rc;rCcr��,d.�� �'v�J ;'.��ll-!� 1 Zc�l �rr��_�,,�� <br />TENANT MAIL ADDPESS CITV 21P � PhIONE�- <br />/. <br />`�VV�l3S�iNL ZCc:�Z «����Alr �f.A-7rC.�—.bvq �I�'7SS ��7r�� 3EZ�� LtSS <br />Ff2HITECTORDE5IGNEP MAILAO�RE55 "L�C � ��+-L'2r_n �ti. ��L�n' r Z'iP PHONE <br />(z�U I-`�t�; ,.�,�=c,�,=;,,,,., t��n <r�i'Ccfi �/u� �fs&:-y4L'�3 <br />GE/NE�R/pL WNTRAGT/Oj�I A1All A/p/ORESS /) CITV �y7 ,/ /ZIP � PHOnNE /) STATE LICEN�SE a <br />�.J/ n..� / ..+�,c�� /'/� /��� hV[i/I1/`1L� � T G7X(� /7���� /1.� l� � =iC'CD 'J� <br />FLUMBING CONTRACiOR <br />CLASS OF WCRN <br />�I i NEW ! '�� ADDITION <br />MAIL ADOPESS <br />ciiV Zlr <br />1 <br />CITV PP <br />a <br />STATE I.ICENSE p <br />SERATION �. �� FEPAIR '�. '� DEh10LITI0N '' WOODSTOVEiFRPL INSERT I 1 BUILDING RELOCATION <br />CONTRACT PRICE O� WORN <br />DESGRIBE WOFK AND SOUARE FOOTPGE INVOLVED <br />rL�.��,�� Sn,ec ln�,.r; <br />PROPCSED USE OF BIIILDING <br />iZ�=S�.n��;z,�ti; ��,r-.R <br />LEGAL DESCRIPTION OF PFOPERTY (SFOVJN BELON <br />LUT __ BLOCK OF <br />PROJECTADORESS <br />NO. <br />OF FIXTURE OR ITEM <br />WATER CL <br />BATHTUB <br />LAVATORY <br />KIICHEN SINK 8 DI; <br />�ISHWASHER ��_{ <br />LAUNDR'f TRAY <br />CLOTHES WASHER <br />UP.INAL <br />DRINKING FOUNTAI <br />FLOOR DRAIN <br />ROOF <br />SINK ( <br />FOR OFFICE USE ONLY: <br />FPONT SETBAGK RCAfl SETBACK <br />USE 20NE <br />TVPEOFTLO�NiS �ALLOWABIE <br />.L-!V <br />SRL OF 6LDG. <br />��� L� �� � <br />OCGUPANCVLOAD <br />AREA <br />� �i CONTACTPERSONFNDPHONENO. ) <br />:'GU � � i,�i��1rn;,-�i� 1=S�f T�i„r-G I/�oG 7��-C-- Sb-1`I <br />COPIES) <br />SUB TOTAL $ <br />PERMIT S <br />TOTAL FEE $ <br />SIDE SETBACK <br />VACANT SITE <br />FEE <br />TYPE OF CONSi. ACiUAL OLCU�AVCV N0.0f UWEIUNGUNliS <br />�^ I cr+ouv �y <br />�V Xl <br />NO.OFSTORIES BASEIMtEnNT <br />I NV <br />FIFESPRNKLEFSREOD HEIGHTLIMITATi01! <br />3 I ti�� <br />REASON FOR SPRINKLERS <br />COU�� MAtc, �a�x. <br />INTAHE BV P�ANS APPi OVED BY <br />CITY OF EVERETT <br />LOCRLSALES <br />TAX CODE IS 3105 <br />l%zti�c/�3� z - az.�s <br />I HEREBY CERTIFY THAT I H� READ A D EXAMINEC THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AI.L <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HE'iEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 'i0 GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTIiORIZED BY THE <br />OWNER OF THIS PfiO?ERTY ?q PERFORM THE VJORK FOR WHICli <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />\ � .� �i��. � �i <br />X �'_l'.�c� c., ��. Z �•t Z� �. 'Z <br />s�,nmruAe onr[ 7— <br />NO. <br />AIC—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNITHEATERS—B.T.U. A�i <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />M1IETAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />SUB TOTAL $ _� <br />PERMIT S � <br />TOTALFEE $ ! <br />�fG <br />BUILDING 2�� JS'� '��� <br />i <br />PLUMBING �_ <br />� <br />MECHANICAL <br />i <br />AD�ITIONAL PL4N CHECK i <br />SPRINKLER i <br />T <br />i <br />STA7E BUILDING SURCHARGE � ��O <br />, <br />PUELIC WORKS "` <br />TOTAL ' �� �j D <br />