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APPLICATIC] FOR CONSTRUCT.')N <br />PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br />259-8910 <br />i DEMOLITION COMBINATION I I BUILDING _, VI ,HANICAL <br />L) PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />C� oYY,pANy <br />TENANT T � IL ADDRESS '�� CITY � ZIP� ' ugm PHt] <br />r���JT <br />is Z3 <br />Ur 4 <br />� <br />C ARCH TECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />CoF 5' <br />TH-1. AFc.rsTik) Y-Ylz �s �JgcuI <br />. <br />�ENERAL CONTRACTOR MAIL ADORES CITY ZIP PHONE <br />STATE LICENSER <br />� lO <br />MECHANICAL CONTRACTOR MAILADDRESS o� , CRY �� <br />STATE LICE I, A A � � <br />IT6T'{AT/�E <br />PL—UMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHON��E{J <br />L•�CENf.S.Eya <br />CONTRACT PRICE OF WORK <br />oo <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />Ao )l `��14 %^ <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPI'CATION 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 ;1EGULATING 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 />`y, <br />TLl1 ►,c, d t, k— 9 -�- ��t <br />PROPOSED USE OF BUILDING 1�' 7 <br />t — <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES' <br />LOT BLOCK of — <br />PARCEL TAXI D. NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRESS. TELEPHONE NUMBER <br />PRO: SCT Ai10RES3 <br />L/ G <br />SfGNAIVRE <br />vjoAtF <br />CitytyB 0i1NML55lM:[NSC NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />N <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />�— <br />LAVATORY ('NASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />; <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />_ <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />HEAT PUMP <br />DACKFLOW PREVENTERS <br />GAS PIPING <br />; <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />I <br />T <br />SUB TOTAL <br />$ <br />SUB TOTAL $ <br />' <br />PERMIT <br />$ <br />PERMIT $ <br />TOTAL FEE <br />$ <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NU OFji97 <br />FE <br />lftW <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />❑ YES ❑ NO <br />BUILDING <br />TYPE OF CONST. <br />NO OF STORIES <br />amp" <br />NO a UNDOING UNITS <br />Gnar <br />PLUMBING <br />SIZE OF BLDG. <br />FIRE SPRINKLERS RED <br />BASEMENT <br />MECHANICAL <br />i <br />17 YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />OCCUPANCYLOAD <br />FIRE ALARM REGD <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />I ' <br />INTAKE BY <br />PLANS ePROVED13Y <br />CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />�� <br />LOCAL SALES <br />DATE _ 8 _ f ( <br />TAX CODE IS 3105 <br />TOTAL <br />'M <br />