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APPLICATIC 1 <br />FOR CONSTRUCT IN <br />PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE <br />PRINT <br />HEATING SYSTEM: J GAS <br />J ELECTRIC ❑ __ <br />BUILDING DEPARTMENT <br />259-8810 <br />i 1 DEMOLITION ❑ COMBINATION <br />I BUILDING <br />f jlL ECHANICAL <br />❑ PLUMBING ❑ SIGN <br />SMAL 610 <br />MAOCITY <br />�l <br />�ZPi FJ i Wo <br />C �% <br />/ <br />IDIA <br />=..?JT MAIL ADDRESS <br />CRY <br />ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE If <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />R <br />PHONE <br />STATE LICENSE) <br />wh Co <br />kIV SE 1-0 T vvMflu. <br />wJ Eo <br />�5� ��31 <br />cJAsrllr�[�2�Sc� <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />ITY <br />ZIP <br />PHONE <br />STATE LICENSED <br />CONTRACT PRICE OF WORKuJ <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAM. NED 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 aPECIFIED HEREIN OR <br />LEGAL DESCRIPTI(N 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 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 />CONTRACTORS LAW 16.27 RCW AND 296.200 WAG. <br />PARCEL TAX IM NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESSwre <br />�`� <br />ri. GusmlTsslcGNSE No <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 />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />) <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <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 />I <br />' <br />I <br />I <br />SUBTOTAL <br />$ <br />SUBTOTAL $ <br />PERMIT <br />$ <br />PERMIT $ <br />/� I <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />rvn vrnA.c voc <br />FRONT SETBACK <br />vl.cl. <br />REAR SETBACK <br />S1DE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />' <br />� <br />❑ YES NO <br />TYPE OF CONST. <br />NO.OFSTORIES <br />=UP Y <br />GP01P <br />NO OF vxallwAlls <br />MECHA141CAL <br />7p� I <br />SIZE OF BLDG. <br />FIRE SPRINKLERS AEG <br />BASEMENT <br />❑ YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD <br />FIRE ALARM REO'O <br />HEIGHT LIMITATION <br />I <br />OTHER <br />I <br />REASON <br />STATE BUILDING SURCHARGE <br />' <br />INTAKE BY PLANS APPROVED I CITY OF EVERETT <br />PUBLIC WORKS <br />LOLAL SALES <br />GATE TAX CODE IS 3105 <br />TOTAL <br />