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APPLICATICA FOR CONSTRUCT'ON PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: i;;J GAS I] ELECTRIC- <br />259-8810 <br />I -1 DEMOLITION I I COMBINATION I I BUILDING MECHANICAL I I PLUMBING I I SIGN <br />OWNER <br />MAIL ADDRESS <br />CITY ZIP <br />PION" <br />/30F_in1G Co. <br />E✓E'/ZSGV u!a S0203 <br />TENANT <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE / <br />GGNE' gOJyIA/ CrJ. <br />AO• fSIJX 2357 <br />6'j&P2L�V0r &✓h9 A 203 <br />( 2U17) 206 i5 0 <br />GENERAL CON TRACTOR <br />MAIL ADDRESS <br />LItY /if, <br />_ <br />PHONE � STATE III0 <br />• <br />J •/�. �. ccn/o. <br />/°o. wx /L ,Epl <br />oc<<c��tr w/9 5su�7 <br />czob) lki • 9cw <br />MEOIIANICAL CONTRACTOR MAIL ADDRESS <br />r✓E't?F?ti/ 1oHra1' <br />CITY ZIP 11IICNL STATE LICENSE <br />7/02 �t{iJr`fXA�-•A>./c;�kc`p 7C -T7.=-4YRA52 C1a6/Lm-Or00 arxrEt4i <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE STATE LICENSE <br />CONTRACT PRICE OF WORN !, <br />/ <br />CONTACT PERSON AND PH,F, NO <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />Y� <br />MAR/Mll /dnrH '91W - n/nn <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APDLICATION 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 DOE; 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 WI(H THE STATE <br />CONTRACTORS L,LW 18.27 RCW AND 296.200 WAC, <br />PROPOSED USE OF BUILDING _ <br />C4C/7v'C/aL />iJiaFn//� ! roc/ <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR AT TACIT TWO COPIES) <br />LOT— BLOCK or <br />PARCEL TAXI D. NUMBEII <br />CONSTIIUC I ION LOAN LLNDLL. AUDIT:5S. 1 LLLPI II NUMBI.I I <br />PROJECT ADDRESS <br />���!-�-�� �*'fP�'B-Ni /�f'Z; G` <br />clly nlrswrsslr.I N.I rn -- -- <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 />_ <br />A/C—A/HNDLG UNITS—H.P. <br />BATHTUB <br />r7RCED AIR SYSTEMS—B.T.U. M E.A <br />LAVATORY (WASH BASIN) <br />�— <br />_ <br />'JNIT HEATERS—B.T.U. M <br />--� <br />SHOWER <br />`_ <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />_ <br />VENTILATION FAN <br />i— <br />DISHWASHER � <br />RANGE HOOD <br />LAUNDRY TRAY <br />_ <br />WATER HEATER_ <br />Cl OTHES WASHER <br />_ <br />r <br />STOVE <br />URINAL <br />_WOOD <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />_ <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GA,; PIPING <br />' <br />ROOF DRAINS—RAINLEADERS <br />--�— <br />EXHAUST FAN <br />I <br />SINK (SERVICE —BAR. (SERVICE —OAR. ETC.) <br />SUBTOTAL $ <br />$ <br />PERMIT $ <br />r— <br />$ <br />TOTAL FEE $ <br />—_T <br />TOTAI FEE $ <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK I ❑LARSETBACK <br />USE ZONE I LOT AHLA <br />TYPE OF cON51 I NO OF STORIES <br />SIZE OF BLDG I HRL SPIIINKLLRS IILO'H <br />OCCUPANCY LUAJ I F,h[ ALAHM PLOD <br />REASON <br />SIDE SE I BACK <br />VACANT SITE <br />I YES I I NO <br />RFnmAw" wN MIHNl:USIIs <br />cRIIUR <br />UISLIALNT <br />(-I YES I NO <br />HE'illT 116VlALG4 <br />INI/,KG DY I'LAN` AUPPOVE I11ly CITY OF EVERETT <br />!/IA LOCAL SALES <br />DATE iJ 21V y TAX CODE IS 3105 <br />FEE !N — <br />Ul11LD'NG <br />PLUMBING <br />MECHANICAL <br />' <br />ADD'IONAI, PLAN GHFCK <br />OTHER <br />l/! <br />STATE BUILDING SURCIIAFGE <br />PUBLIC WOIIKS <br />TOTAL <br />