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APPLICATI" <br />FOR CONSTRUCT 11 ��[ j l�Pl <br />" <br />TO BE COMPLETED IN BLACK INK <br />—PLEASE PRINT II <br />�� <br />- SEP - 0 1994 <br />HEATING SYSI•EM: ❑ GAS <br />❑ ELECTRIC U ........ <br />-- - ---- --. -•- ••-• ...... I <br />BUILDING DEPARTMENT <br />— <br />259-8810 <br />Public Works Dept. <br />O DEMOLITION F I COMBINATION <br />❑ BUILDING <br />F I MECHANICAL <br />X PLUMBING SIGN <br />OWNER MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />TENANT MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />Marl ✓1 St.. �g���.1 0'(n <br />r i 3'm /�adi <br />4g� � f- Ev&e1L <br />ciaoa 3S3 3JlD <br />ARCHITECT OR DESIGNER MAILADDRESS <br />CITY <br />IF PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STALE LICENSE <br />MECHANICALCONTRACTOR MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE# <br />LAYA/I01o7'7r.1*) <br />PLUMBING CONTRACTJR AIL ADDRESS <br />T J A('L A I . T <br />CITY ZIP PHONE <br />NO a-, in71 /.,nn..,r. a <br />STATE LICEN <br />apf)46. %2nLS a 77.5�4�6�h <br />T <br />CONTRAC PRICE OFWOBK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPFCIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY 'SHOWN BELOW OR ATTACH TWO COPIES) <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW R� GULATING CONSTRUCTION OR THE <br />a it ,,,, - �Ju^'�Sa, � v{,,_ �C <br />a �• <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />- <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />COP) A TORS LAW 18.27 RCW AND 296.200 WAG. <br />PARCEL TAX 10, NUMBER <br />—Q <br />7 <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />X-- <br />_ <br />PROJECT ADDRESS <br />smug. ontE <br />cn rxus1Nmess ucEusE mo <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />NO, TYPE OF EOUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A/C—AIHPIOLG UNITS—H.P. <br />BA"i HTUB <br />FORCED All"f SYSTEMS--B.T.U. .A. M E <br />' <br />LAVATORY (WASH BASIN) <br />I <br />UNIT 4EATERS—B.TU. M <br />SHOWER <br />_CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HGOD <br />' <br />LAUNDRY TRAY <br />; <br />— <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />URINAL <br />; <br />— <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />_ <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />� <br />_— <br />� st7[.LGAa <br />SUB TOTAL $ <br />1 <br />/ }. 60 <br />SUB TOTAL $ <br />I <br />PERMIT $ <br />O <br />PERMIT $ <br />TOTAL FEE $ <br />a-_;L:0a <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: _ <br />FRONT SETBACY. REAR SETBACK <br />USEZONE I LOTAREA <br />SIZE OF BLDG. <br />NO. OF STORIES <br />FIRE SPRINKLERS RECTD <br />INTAKEBY PLANS APPROVED BY <br />DATE <br />SIOE SETBACK PLAN <br />❑ YES ❑ NO _ <br />BUILDING <br />OCCUPANCY <br />NR00° <br />NO Of MLLINO UNITS <br />— <br />PLUMBING <br />MECHANICAL <br />BASEMENT <br />❑ YES a NO <br />— <br />ADDITIONAL PLAN CHECK <br />HEIGHT LIMITATION <br />— <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />RECEIPT NO. <br />H <br />