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�r7 <br />S I-7 <br />9 H N <br />O 5o <br />'-7HTJ <br />] En L~ <br />O m <br />OHd <br />�d 0 u <br />Hho <br />V n <br />H <br />Z H <br />ta" H z <br />H 3 <br />Cn <br />H <br />(qg� C7 co <br />Z H CO <br />H3 O C4 <br />APPLiCA'TIt.aq FOR CONS'TRUCI _ON PERMIT <br />TO BE COMPLETED IN FLACK INK —PLEASE PRINT <br />HEAT MG SYSTEM: GAS ❑ELECTRIC ❑ 1 <br />BUILDING DEPARTMENT L- <br />259-8810 <br />DEMOLITION ❑ COMBINATION BUILDING /MECHANICAL L GLUMBING SIGN <br />OWNER MAILADDRESS CITY ZIP PHONE <br />1L1I�1rs,_A n„n,c,7- :n.. /Lii Ant Al f 9tsoZ/ YF/— v ,7x <br />TENANT MAIL ADDRESS C1T);5 <br />+h /'1e i1-C PHONE <br />ARC iTECTORDESIGNER MAILADDRESS CITY JZIPP PHONE <br />Prs:tiA) /2GaP57- krtekT1" Sc/7- eo <br />PHONE <br />N <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE <br />f HF - <br />5- <br />PLUMBINGCONTRACTORMAIL <br />ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE• <br />lG � <br />I L v/k I,6: y <br />CU/SSO WORK <br />! n�cu, n AnnlnnM n AITPDATInM <br />F-I RFPAIR Fl DEMOLITION <br />❑ WOODSTOVE/FRPL INSERT <br />Cl BUILDING RELOCATION <br />CONTRACT PRICE OF WORK / ��� <br />WNTACT}1Efl$ON AND PHi N74 <br />C/p}✓���J/' <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />,Up-w Iles . !.z yeg <br />g <br />PROPOSED USE OF BUILDING ov <br />S i/ 4n L eS <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 />CR CTORS W 18.27 RCW AND 296.200 WAC. <br />X IF z <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIESI <br />LOT BLOCK of <br />p <br />1 D ! S /l6 nfi ®L� T / z062�m - ,t <br />SP wleaz ' -ci f <br />PROJECT ADDRESS <br />2 Wjj <br />5ATURS DAIS <br />KPI <br />cm euslKrss LkcNse xD <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 />— <br />AIC—A(HNDLG UNITS—H.P. <br />_ <br />BATHTUB <br />— <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />2 <br />LAVATORY (WASH BASIN) <br />— <br />UNIT HEATERS—B.T.U. M <br />i <br />SHOWER <br />' - <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP <br />VENTILATION FAN <br />; <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />i <br />URINAL <br />METAL FIREPLACE& CHIMNEY <br />' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />1 <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />' <br />_ <br />EXHAUST FAN <br />I <br />SINK (SERVICE -BAR, ETC.) <br />i <br />_ <br />I <br />I <br />I <br />I <br />SUS TOTAL <br />$ <br />- <br />SUB TOTAL--$ <br />_ <br />PERMIT <br />$ <br />I <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />' <br />FnR nFFICF IIRF C1NI V. <br />FRONT SE'fBAC,ola% <br />REAR SETBACK <br />SIDE SETBACK <br />PLANCHECK N�UMCBEfl <br />FEE 0— <br />RECEIPT NO. <br />S <br />�/ <br />0 <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />`-z- <br />BUILDING <br />64.350 <br />' <br />j <br />TYPE OF CONTS. ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />=PWY <br />xD. aF DNRxlxeuxns <br />�_�J <br />_ <br />GROUP <br />PLUMBING <br />— <br />i <br />SIZEZ?BLDG. <br />sf <br />NO.OFSIORIES <br />BASEMENT <br />MECHANICAL <br />Ui <br />o SF <br />O <br />ADDITIONAL PLAN CHECK <br />91 <br />77 <br />=CUPANCYLOAD FIRE SPRNKLERS REOD HEIGHT LIMITATIp1 <br />!,�JG$l _ <br />SPRINKLER <br />' <br />REASON FbRSPRINKLERS <br />� <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVER ETT <br />PUBLICWORKS <br />// <br />ZO <br />LOCAL SALES <br />J <br />TAX CODE IS 3195 <br />TOTAL <br />70 1 Q' <br />