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�) APPL.ICATIC I FOR CONSTRUCT )N PERMIT,' --' <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT I HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />259.8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING X SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />- 9 Ase ^ uTy i9a/ ��.9✓E. w &io sr.� r7S- � '?S101 69z 3i0o <br />TENANT MAIL ADDRESS CITY ZIP PHONE -- <br />�XlY rB�i1Yl7�'sdF�l,>' 3c25'sE,C✓6L�,ETl'.yrICL »y a�9 Er��tET!' 99208 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE 0 <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />ZIP <br />LICENSE a <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE# <br />x NEW ! I ADDITION I ALTERATION REPAIR nFAATTI ITI()M I ulnnnem.— - . _.... _...- __. _ _ <br />1/ <br />- �•••••�... i uulLulrvV MCLVVMl IUV <br />CONTACT PERSON AND PHONE NO. <br />CONTRACT PRICE OF WORK Sao <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />.Adr�� y7YC 4' 4X,-.5AF16e <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />R47,V,'-- <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />toi BLOCK 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 />�'� •�N5,Lc� <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />o s�rE ,oGr9� oe9w�ru6 <br />CONTRACTORS LAW 18.27 ROW AND 296.200 WAC. <br />PROJECT <br />dSIG <br />ADDRESS ...iOS ,3r, Sy,5�£TT M, /,, '�•d� <br />OH�DZDV,E <br />E'FlSfTT, w.9 99�0® <br />CRYOUSxESSIICENSENO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF ED IDMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />LEE <br />WATER CLOSET (TOILET) <br />I <br />A/C —A HNDLG UNITS—H.P. <br />_ <br />; <br />BATHTUB <br />; <br />_ <br />FORCED AIR SYSTEMS—S.T.U. M E.A. <br />_ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />' <br />SHOWER <br />' <br />CLOTHES DRYERS <br />�— <br />KITI:HEN SINK & DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRYTRAY <br />1 <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />; <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />�— <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />, <br />BACKFLOW PREVENTERS <br />' <br />GAS PIPING <br />1 <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />, <br />, <br />--�— <br />SUB TOTAL $ <br />SUB TOTAL S <br />PERMIT $ <br />I <br />PERMIT $ <br />; <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMB4R <br />FEE <br />RECEIP <br />_ <br />usEzoNE <br />LOT AREA <br />VACANTSITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />Ji <br />V <br />PE OF CDNiS. ALLOWABLE <br />TYPET. <br />AC <br />TYPE OF CDNSTUAL <br />ac[coANtT <br />No amttunv uxn5 <br />GnWc <br />PLUMBING <br />, <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />' <br />OCCUPANCY LOAD FIRE SPRINKLERS REDID HEIGHT LIMITATION <br />ADDITIONAL PLAN CHECK <br />W 1. <br />SPRINKLER <br />i <br />�, T <br />REASON FOR SPRINKLERS <br />S1ATE BUILDING SURCHARGE <br />' <br />INTAKE BY <br />PLANS PP 1VED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />1 <br />LOCAL SALES <br />' <br />TOTAL <br />TAX CODE IS 3105 <br />