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APPLICATIC �l FOR CON�TRUCT' �N PERM7T � <br />f0 BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS :J ELECTRIC J_. —� <br />BUILDING DEPARTMENT - <br />259-8810 <br />DEMOLITION ' i COMBINATION BUILDING MECHANICAL � 1 PLUMBII�G X SIGN <br />OWNF.R �AAiLADJRESS C17V ZiP PHONE <br />BILLIE LUNSFORD 10025 4th AVE. WEST, EVERETT WA 9820d 206-776-0609 <br />TEN�Ni �IdA�ILAOi�� E5�5 GIiY IIP PMONE <br />SAME ��'Z/.�11�. �yUL�� / _ <br />G[NEPAL <br />MECNFNICAL GONTRI.CTON <br />PWMBIN� CCNTRACTOR <br />IAAIL ADDREdS <br />MAtL ADDRE55 <br />MAIL A�DRE55 <br />M�IL ADDFESS <br />CONTRPCi PRICE OF W�RK <br />$542.00 <br />DESCRIBE WORK AND SOUARE FOOiAGE INVOLVED <br />arv zm i <br />2/ .�nnn2 <br />f.�,iY ZiP I <br />Cliv ZiP I <br />CITY ZIP <br />� CANIAGT PER30N RND PHONE t10. <br />SIGN FOR STORE. DOUBLE SIDED WITH SIGN <br />EACE AT 3'x5' Itv SIZE (15 sq.ft.) MOUN <br />PROPOSEO USE OF 9UILDING <br />CLOTHING STORE — CONSIGNMENT <br />LEGFL DESCRIPTION Of PPOPERTV iS110WN OcLOW OR ATiRr,M i WO COPIES) <br />LOT—� OLOGK OF -- <br />PAFCELiA%IA NUMOER <br />CONSTRUCTIONIUANIEN�GR. <br />PROJECTADDRESS <br />WATER ClGSET (TOiL <br />BATHI'UB <br />LAVATORI' (WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />7RAY <br />URINAL <br />FLOOR iRNN <br />BACKFLJW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SEHVICE—BP.R. ETC.) <br />FOR OFFICE USE ONLY: <br />FPONTSETpAGH RF.RR: <br />US�E �ZONE <br />l.. � <br />irre or eoxs� <br />SIZE OF BLOG. <br />OCCUPANCYLOAD <br />iiEA501J <br />IryiAHE BY <br />NUMOER <br />TOTAL $ <br />NIT $ <br />;L FEE $ <br />IUTAREA <br />NO.OF STORIES <br />PV'E SPRINhLERS REO'D <br />FIR[ ALPRM RE00 <br />PLANSAPPROVEDBY <br />oarE JM�iG�94 <br />597 <br />SiATE UCENSE / <br />SiaTE LICENSE • <br />STAtE LIGENS@ 1 <br />LARS LINDER 206-353-5547 <br />ON WOOD 4"x4" POSTS. <br />� HEREPY CER7�FV THAT I HAVE READ A�:D EXAMINED Tr11S <br />APPLICATION ANC- KNOW THE SAME TO BE TRUE AND CORAECT. ALL <br />PP,O'lISIONS OF LAWS AND GqDINANCES GOVcRNINC THIS TVPE OF <br />WOPK WILL BE COMPLETED WITH 1NHEtHER S�ECIFIED HEREIN OR <br />NOT. THE GRAIJTING OF /� PEFiM1T DOES NOT pRESUME TO :iIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIDNS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE <br />PE�iFORA1ANCE OF CONSTRUCTIQN. TH4T I AM AUTHOflIZED BV TI1E <br />0`VNER OF THIS PROPERTY TO PERFORM THE WORK FUR WHICH <br />A:'PLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONT A�CT�ORyS �LA�W 79. RCW AND 296.200� � <br />`s��./qv� i/V.�.� <br />_'I ' <br />�-i� �l�1� `_ <br />ac uncnecnoi M_74VFQd <br />FEE N0. TVPE OF EQUIPMENT <br />A/G—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEUS�—B ;.U. M E A. <br />, UNIT HEATERS—B.T.U. M <br />VENTILhTION FAN �_ <br />RANGEHOUD _ � <br />WOOD STOVE <br />MEIAL FIREPL <br />FIflEPLACE IN; <br />HEA'PUMP <br />GAS PIPING <br />EXHAUST FAN <br />SIpESETEA�N � PVdJpdCK <br />V�CANTSITE ' �e�� <br />�^� YES � . NO 6UILDING <br />occuPnecv xaorv.v��exemna -- <br />e>mv I p�UM81NG <br />BnSEMENT MECHANICAL <br />�l YES � �. NO <br />HEiGHiuMITAnON ADDITIONALPLANCHECK <br />���� � � OTNER <br />STATE BWLDING SURCHARGE <br />CITY OF EVERETT cuouc woaKs <br />LOCAL SALES <br />TAX CO�EIS 3105 TOTaL <br />FEF <br />SUB?OTAL 5 <br />PEFMIT 5 <br />TOTALfEE $ <br />% � Q (� <br />� OS <br />0 <br />