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F <br />�H <br />�xyHx!~i� <br />HXH <br />k <br />��GG CA <br />CA <br />L+1z� <br />OFH-IG <br />CPS <br />n� 0 <br />t"H <br />1..4 H3 <br />y <br />0tv CAA <br />1H fn <br />HOCn <br />APPLICATION FOR CONSTRUCTI( N PERMIT <br />theErmra,eeR TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY OF <br />everett HEATING SYSTEM: GAS U ELECTRIC U _ <br />BUILDING DEPARTMENT <br />259.8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />CITY ZIP PHONE <br />Z31S fcCL,tt rrb c�a5yz�i zs5- �gZs <br />TENANT l MAIL ADDRESS CITY ZIP PRUNE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />I - NRW ✓AnnITION ALTERATION REPAIR DEMOLITION WOODSIOVE/FRPL INSERT I- BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />CONTRACT PRICE OF WORK 3s r/^�''11�_ v CO <br />DESCRIBE WORK ND SOU FOOiAf INOOLVED <br />AI <br />PROPOSED USE OF Bun <br />INC <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />SI' <br />/I r <br />IN1'IL�tl�l <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL DES& PTION OF PROPERTY SHOWN BELOW OR ATT :HFOURCOPIES) <br />l� L�'d®F <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT l Z RLocK3b <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 />CONTRACTORS LAW 18.27 RCW AND 296,200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZEDAG,ENTTJ�J /DATAATT,EE <br />�L1/4 / CE r.L <br />PROJECT ADDRESS yyl <br />1<ZL( Mc `r�1 <br />ELrI l �/�Ll� ,V <br />NO ANDBI <br />APPLICANFS CITV BUSINESS LICENSE NO. AND BUSINESS NAME <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />_ <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />5�I <br />AC—AIHNDLG UNITS—H.P. <br />i <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />i <br />SHOWER <br />CLOTHES DRYERS <br />1 <br />KITCHEN SINK 8919P <br />— <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />1 <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT <br />i <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />p I <br />EXHAUST FAN <br />1 <br />SINK (SERVICE —BAR. ETC.) <br />1 <br />1 <br />I <br />SUB TOTAL $3' <br />O I �' <br />SUB TOTAL $ <br />v Ia e <br />PERMIT $ <br />PERMIT $ <br />�— <br />TOTAL FEE $ <br />30 <br />TOTAL FEE $ <br />pno fTFFICF I IRP nml V. ')� P " <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK A� <br />PLAN CHECK NUMBER <br />FEE G5 <br />RECEIPT NO. <br />S�10N <br />y/ d631-1� <br />,I ZO�C)I <br />/5 zz <br />USE ZgK <br />LOT AREA <br />VACANT' <br />FEES <br />VALUATION <br />FEE <br />-Z- <br />C-y000 <br />LSITE <br />nJ�+ <br />BUILDING <br />- 1 <br />TYPE Of CONTS ALLOWABLE <br />TYPE Of CONST ACTUAL <br />mcow, <br />I NO Oimlll"0uvrt2 <br />_ <br />48w3 <br />PLUMBING <br />,SO i Oe <br />--T <br />SIZE OF BLDG <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />Id0 <br />IO33 Sr ADDTIJ <br />2 <br />IO <br />_-no <br />ADDITIONAL PLAN CHECK <br />I <br />OCCUPANCYLOAD FIRE SPRNKLERS REDD HEIGHT LIMITATION <br />NO 2i' A <br />OTHER <br />----i-- <br />REASON FOR SPRINKLERS <br />SURCHARGE <br />STATE BUILDING <br />$'a <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />j <br />✓y( <br />LOCAL SALES <br />4 N <br />TAX CODE IS 3105 <br />TOTAL <br />SG y <br />