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APP�ICATIC�I FOR CONSTRUCT'-1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEAT�NG SYSTEM: ❑GAS ❑ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> I I DEMOLITION � i COMBINATION I 1 BUIIDING I I MECHANICAL ' I PLUMBING i i SIGN <br /> OWNER MAII�OCilE55 CITY ZIP PNOf1E <br /> Edmund Clark P.O. Box 83 Lakewood 98259 (206)652-1112 <br /> 1ENRNT �.1��LAO�RESS C:TY IIP PHONE <br /> ��CHITECTORDF.SIGNER M�ILADDRESS p1Y ZIP PN04E <br /> Gary Parkinson 2812 Colby Ave Everett 98201 (206)252-2153 <br /> GENEP.ALCONTRRCiOP AIRILADDRE55 LITY IIP PNONE STpTELICENSE� <br /> Owner P.O. eox 83 Lakewood 98259 (206)652-1112 <br /> MECNANICALCONTRRCTOA MRIL�O�RE55 QTY ZIP PH01lE ST�7ELIGENSE� <br /> PIUMBINGCONTPRCtOR M�IL�UDRESS CITV ZIP PnONE ST�TEl10EN5E� <br /> LONTR�CTPRICEOF ORK � <br /> � �� <br /> DE IOE WOR AN SWME FOOTAGE INV V CO TRCT PER N AN PHONE NO <br /> �'enan� �mprovemen�` �'or a rie�a drive- �ary �ar inson 252-2153 <br /> thru kitchen 2,196 sq. ft. <br /> S � � � / / i HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PPOPOSEDUSEOFBUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> Dr ive thru Ki tchen PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF ' <br /> LEGRI DESCRIPTIONOFPROPEATY�SNOWNBELOWORATiRCNTYOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> iot 46 B�aK 693 � BLK 693 D-OO- NOT. THE GRANTING OF A PEAMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> ALL LOT 47 AND W15 FT OF LOT 48 BLK693 OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFOFA7ANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF iH15 PROPERTY TO P RFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE D I COMPLY WITH THE S?ATE <br /> PARGRTA%ID.NUMBER CONTRA O LAW1B � W D296200WAC. <br /> 4�qn �q� 046-0008L4'�90-693-047-0 l <br /> GONS7RUGTION LO�N IEN�ER.�DDRESS.TELE�HONE NUMBER � •n/] [�/� <br /> L��� �� <br /> PROJECT ADDRESS ` + "r <br /> -'�'^ � ., ' e � Everett WA �� ,s�. � : ��� � <br /> PLUMBIN6 MECNANIChL <br /> NO. TYPE OF FD(fURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> � WATER CLOSET(TOILET) � AiC—AiHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M I <br /> SHOWEfi CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGEHOOD <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> UHINAL ' METAL FIREPLACE�WOOD BURNING) ; <br /> DHINKING FOUNTAIN � F�REPLACE INSERT � <br /> T <br /> FLOOR DRAIN � HEAT PUMP ' _ <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ET0.) ; — <br /> � � <br /> � — <br /> . , <br /> SUB TOTAL S ; SUB TOTAL S _ <br /> PERMIT $ � PERMIT $ _ <br /> TOTAL FEE S ' TOTAL FEE $ —T <br /> FOIi OFFICE USE ONLY: <br /> fPON75E7BRGN REARSE7fl�CN SIDESEiBACN PLANCNECNNUMOEq FEE �F.f,EIPTNO <br /> p ' '- ' ,a�"�o• y����Co 3S. /v /Os���� <br /> use zor+e ior nAea VACANT SITE FEES VALUATION FEE <br /> L�� f i YES 17 NO BUILDING r2� �c � — <br /> 7vr[oifox;t NOOFSi0R1E5 acur.xc xoc�rnvnuxr,mui+s <br /> •r/7 � rqpp° �✓ pLUMBING � <br /> ._kJ�! � ---�— <br /> SIZEOF�B"LDG FlRE.SPtRINNlER5RE0'U BRSEMENT MECHANICAL ' � <br /> II �{p /vJ �VES f� NO � <br /> OCCUPA/N�CY LOAD FlRE ALA�F�Mx REOD NEIGHt LIMITA�ON ADDITIONAL PLAN CHECK ��g �� <br /> Y � /w' `TV OTHER ' <br /> r <br /> REASON '�—�` <br /> STATE OUILDING SURCHARGE (� <br /> INUKE BY PLANS(�PRpVEDBV CITY OF EVERETT PUO�IC WORNS /y!(��-i � <br /> �JNI LOCAL SALES <br /> onrr �� �p q' - TAI(CODE IS 3105 Torai. 2(��]j - <br />