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3a <br />APPLICATIOIN FOR CONSTRUCTION PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: U GAS U ELECTRIC U <br />259-8810 <br />11 DEMOLITION I I COMBINATION I I BUILDING I I MECHANICAL }q PLUMBING 1_1 SIGN <br />owr+Tn MAIL ADDRESS cl'Y ZIP PHONE <br />bE�g&a- vims P�O.LA '1-70-7 9P(z4-s2o7 <br />TENANT MAIL ADDRESS PITY ZIP PHONE <br />ARCHI TEL I OR DESIGNER MAIL ADDRESS CITY ,'IP PHOWE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br />1a2tn ;Q 7QX102'1 EASTAVS—"E 5eA 9210Z 3Z9-11-21 <br />MEC ANICALCONTnACTOR MAIL CITY ZIP PHONE STATE LICENSE IT <br />D. ODRESS d�Q7 :!5n1a g81Z�:7(oz-3311 1pceryf 7.]nl0 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE I, <br />Z Nn t" <br />C TRACT PRICE OF WORK <br />r% ('o 4Tn <br />DIESCRIElf WORK AND SOVARE TOOTAGE INVOLVE D — <br />ION I';KA� <br />f� <br />�T ANDPIIONE NO 7 I <br />E 'I Al S�LI 'In <br />�SINV: <br />__Z <br />`-^'""44 <br />I 1 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 CA THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR17ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK F )R WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS L 18.27 RCW AND 296.200 WAC. <br />///`DOE <br />PACnSED <br />aj"� <br />USE Of 9UILDING ., ` <br />U ALP 44 fUtz 6 <br />LEGAL EC SCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT— BLOCK OF <br />_ <br />PARCEL TAX I O NUMBEH <br />CONSTRUCTION LOAN LENDER, ADDRESS, TELEPHONE NUMUER <br />PROJECTADDRESS 2AIb FIOOR <br />13 0 3. 1 - 1 <br />1_10 <br />CI Y t1ILICLHL <br />PLUMBING <br />MltHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />_ <br />WATER CLOSET (TOILET) <br />AC—AIHNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />I <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />; <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />_ <br />; <br />WATER HEATER <br />r <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL _ <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />I <br />_ <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />I <br />SINK (SERVICE —BAR, ETC., <br />_ <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />i <br />7JTAL FEE $ <br />TOTAL FEE $ <br />r <br />FOR OFFICE USE ONLY: % % 0-0 <br />FRONTSETBACK <br />BEAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMnEH <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />17 YES FI NO <br />BUILDING <br />TYPE OF CONST. <br />NO. OF STORIES <br />ocaruc. <br />WaaMHIYc 11YIIi <br />— <br />PLUMBING <br />— <br />I <br />T <br />cnar <br />52E OF nlDO. <br />FIRE DP91NKlE05 REOD <br />BASEMENT <br />MECHANICAL <br />I <br />F1 YES n NO <br />ADDITIONAL PLAN CHECK <br />� <br />OCCUPANCY LOAD <br />FIRE ALARM BEOD <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />—i— <br />STATE BUILDING SURCHARGE <br />INTAKEDY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />