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APPLICATIQ""° FOR CONSTRUCT�"1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS U ELEC7RIC ❑ <br /> 259-8610 <br /> ❑ DEMOLITION }�1 COMBINATION 17 BUILDING ❑ MECHANICAL I7 PLUMBING ❑ SIGN <br /> OWNER AIMLADDRE55 dTV ZIP PHONE <br /> William & Barbara Lindsey 8910 - 60th Dr. N. E. , Marysville °8270 659-6096 <br /> TBNANT blAll ADDRE55 CITV ZIP PHONE <br /> ARCHITECTORDESIGNEfl MAllA0DFE55 CITY ZIP PMONE <br /> GENERALCON�RRCTOR MqILADDRESS CIN 21P PHONE STATELICENSEt <br /> R.C. Enterprises 2315-189th P1 .N.E. ,Arlinqton S4A 98223 652-7070 601 126 819 <br /> MECHANICALWNTRACTOR MRILADDRE55 CITY ZIP PHONE STATELICENSE• <br /> Evergreen State Sheet Metal, Inc. P. 0 Box 1508 Everett WA 98206 <br /> PLUMBINGCONTRACTOR MAILAUDflE55 CITY ZIP PMONE STATE�ICENSE� <br /> R.C. Enter rises Same as above <br /> CONTRACi PRICE OF WORK <br /> �1191���.�� <br /> SCRIBEWORK N SOUAREFOOTAGEINVOLVED CON7ACTPEP ONANDPHONENO. <br /> ew res�c�ence Ralp�h Peterson 652-7070 <br /> lst floor__1284 sq. ft. Basement : <br /> 11Vinq area--648 S ��. ft. 4ata e--636 5 . t,.,iEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEDIISEOFBUIIDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Re S i dence PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCFIPTIONOFPqOPERTV�SHOWNBELOWORATfACMTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT 4 oL�N 260 _ oF Everett D].V � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <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 /> PARCELTA%I.D.NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> 4383-260-004-0005 CONTRACTORS LAW 1827 RCW AND296200 WAC. <br /> CONSTRUCTION LOAN LENDER.AODRESS,TELEPHONE NUMBER x�i � �� / /� � <br /> �� <br /> PROJECT ADDRESS s�ca mnc ' �F- o�re ��7 <br /> 7 LiiY BUSiNE55 L'CENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> . WATER CLOSET(TOILET) /:'/ � A/C—NHNDLG UNITS—H.P. <br /> BATHTUB / ; 1 FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) �� � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � 1 CLOTHES DRYERS �� <br /> KITCHeN SINK&DISP � ; VENTILATION FAN ; <br /> DISHWASHER � 1 RANGE HOOD � <br /> LAUNDRY TRAY / ; 1 WATER HEATER ' <br /> CLOTHES WASHER � � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT d S � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; 3 GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � Q E%HAUST FAN :'//' � <br /> SINK(SERVICE—BAR,ETC.) ; ; <br /> � � <br /> � � <br /> � <br /> � � __ <br /> � � <br /> SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTAL FEE S ; TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACN qEMSETBACN SIDESETBACK PIANCHEG -NUMBER FEE �I AECEIPTNO. <br /> � ' 3 lv�3 /��'� �y 3'l <br /> use zoNe �OT AREA VRCANi SITE FEES VALUATION FEE <br /> � � 8� ❑ YES ��! NO BUILDING � �— <br /> TVPEOfLONS[ NO.OFSTORIES o[[uPSNtr NOOfbntui!�GUNus D � y�) <br /> U ' <br /> , GAO�� � PLUMBING � <br /> SIZEOFBLSf r FIRESPRINKLERSREO'D BASEMENT MECHANICAL �D ' <br /> �� S a,C N� ❑ YES C� NO <br /> OCCUPAN1C'VLOAD FIREALARMRE�D HEIGHTLIMITATION ADDITIONALPLANCHECK �� <br /> /`� NV �, OTHER .�� D� <br /> REASON <br /> STAT[BUILDING SURCHARGE L/i�� <br /> INTANE BY PLANS AP ROVEOOV CITY OF EVERETT PUBLIC WORKS LUi�J� <br /> � N LOCALSALES <br /> on.e � 3� c� TAX CODE IS 3105 TOTAL �L� �g <br />