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BUILDING DEPARTMENT <br />259-8810 <br />ATI( 1 FOR CONSTRUCT )N <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS ❑ ELECTRIC IJ <br />PERMIT � <br />❑ DEMOLITION CI COMBINATION ! BUILDING f J MECHANICAL f 1 PLUMBING C� SIGN <br />OWNER MAIL pODFE55 <br />CITY ZIP PHONE <br />Allan L. White 717 Rucker Everett 98201 259-2707 <br />TEN�NT MRIL RODRE55 <br />CITV ZIP PHONE <br />FRCMIiECTORDESIGNEP MAILAODRE55 CITY 21P PHONE <br />Nickerson Architecture 2520 Colby N106 Everett 98201 259-1560 <br />G[NERALCONTqpCTOR MRIL�D�PESS CITV ZIP PHONE STRiELICENSE� <br />Not selected yet b'_C l�j <br />MECNANICAL CONTqpCTOR MAiL ADDRE55 CITY ZIP PHONf STRTE l ICENSE / <br />r�umumtiCONTRACTOR MAILR�DNE55 <br />a2����r ��a��7 <br />4�ONTRi1CT PRICE OF WORK <br />E;,timate E35,000 <br />�ESCNIBE WORK RND SOURFE FOOTAGE INVOLVED <br />1/i�.� ;fr'�,� '�7 <br />PROPOSED lISE OF BWL�ING <br />� cara�e <br />LEGRL DETSCRIPTION OF PPOPERTY (SHONRJ BELOW OR AiTACH TWO WPIES� <br />�or�9.,10.,}]��K_136—oF Grandview Addition <br />G <br />PARCELTA%I.D.NUMBER <br />4588-136-009-0005 <br />CONSTRI:CTION LOAN LENOER. ADDRE55. TELEPHONE NUMBER <br />rvPe oF <br />CLOSET <br />SHOWER <br />KITCHEN <br />DRAIN <br />OW PREVENTER� <br />FOR OFFICE USE ONLY': <br />FRONTSETBACK qGRSIitBALK <br />�o ,� <br />USE2/ E �pTqREA <br />/ ' /� /r / _i <br />TYPCOfC�N57. NO.OFSTORIES <br />SIZE <br />OCCUPANCV <br />FlRE SPRINKLERS PGO'D <br />FIFC 4LARM REO� <br />5 <br />$ <br />S <br />ZIP <br />N0 <br />Res. 259-2707 <br />PHONE STFiE LICENSE • <br />Bus. 258-9222 <br />i 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 .4ND ORDINANCES GOVERN'NG 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 ANV <br />OTHER STATE OR LCCAL 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 WHIC4 <br />APPLICATION IS MADE AND I COMPLY WI1H THE STATE <br />CONTRACTORS LAW 7B27 RCW AND 296.200 WAC. <br />� ./ / —��� <br />SKN.11ui�' �f�liLVV�i `% �IT �`�J <br />ORC <br />i UNITS-H.P. <br />iVSTEMS-B. <br />S-B.T.U. M <br />fERS <br />FAN <br />METAL FIREPLACE i <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIOE SET6ACK pLAN CHECY <br />�' � <br />VAC4NT SITE F <br />❑ YES � NO BUILDING <br />aa�excv �uo m o�vewrve uxns <br />ceou� <br />N_� � PLUAIBING <br />❑ YES �O <br />� <br />1KE 9Y PLANS APPRO�'�DBV CITY OF EVERETT <br />',�1 � �% �� LOCAL SALES <br />omecx/ o.�o TAXCODEIS3105 <br />MECHANICAL <br />PDDITIONAL PLFN CHECN <br />OTHER <br />STATE BUIL�ING SUFCHARGE <br />PUOLIC WORKS <br />TOTAL <br />BC <br />SUP?O?Al $ <br />PERMIT 5 <br />TOTAL FEE $ <br />FEE <br />�o.,�o <br />FEE <br />a <br />2! <br />