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APPLICATIC 1 FOR CONSTRUCT 3N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT NtAI INU SYSTEM: ❑ GAS ❑ ELECTRIC ❑ SPRINKLER <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY <br />Blank & Blank Properties P.O. Box 2266 Everett WA ZIP820 PHONE <br />TENANT MAIL ADDRESS 9 3 355-4725 <br />CITY ZIP PHONE <br />ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />Blank & Blank Properties <br />P.OU Box 2266 <br />Everett <br />WA 98203 <br />PHONE STATE LICENSE <br />355-4725 <br />MECHANICAL CON T HACTO'i <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE STATE LICENSE. <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />Robinson Plumbing <br />CLASS OF WORN <br />Inc 607 SE Ev Mall <br />Way N26, <br />PHONE STATELICENSEA <br />Everett, WA 98208 355-6171 ROBINP*272C2 <br />X NEW ADDITION <br />ALTERATION RFPAIG <br />-- -_.....",,­. <br />..vvuo I LJVGrHHL INStHT BUILDING RELOCATION <br />CONTRACT PRICE OF WORK $900.00 <br />CONTACT PERSONAND PHONE NO <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />Sprinkler <br />PROPOSED USE OF BUILDING <br />SFR <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />LEGAL DESCRIPTION OF PROPERTY <br />)SHOWN BELOW OR ATTACH FOUR COPIES) <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LOT BLOCK OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />- <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 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.�2000 WA'. [ <br />X V -Ir C/// <br />PROJECT ADDRESS <br />SGNAIp9F <br />pAiC <br />1704 Scenic Drive <br />PLUMBING <br />CITY BUSINESS I ¢CNSE NO <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A'C-A/HNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />. <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />i <br />VENTILATION FAN <br />I <br />DISHWASHER <br />I <br />RANGE HOOD <br />— T- <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />i <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT <br />I <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />` <br />SINK (SERVICE -BAR, ETC.) <br />I <br />� <br />' <br />I <br />I <br />I <br />I <br />SUB TOTAL $ <br />; <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />ono nrrinr <br />TOTAL FEE $ <br />nn� ..u. .. <br />I <br />TOTAL FEE $ <br />FRONTSETBACK <br />REARSETBACK <br />SIDESETBACK <br />ECK NUMBER FEE <br />RECEIPT NO. <br />j , 10USE <br />�v <br />JO R' `FEES <br />ZONE <br />LOT AREA <br />VACANT SITE <br />VALUATION <br />FEETYPE <br />GOCCUPANCY <br />OF CONTS. ALLOWABLE <br />TYPE OI CONST.ACTUAL <br />NoawrtLLINGLNiTS_BnwvNG <br />'SIZE <br />OF BLIX3.BASEMENT-- <br />-- -'-�— <br />ICALIOCCUPANCYLOAD <br />MCHECK <br />FIRE SPRNKLERS RED D <br />HEIGHT LIMITATION <br />NAL PLAN CHECKREASON <br />ER �8 Reads) <br />20�.00UILDING <br />FOR SPRINKLERS <br />SURCHARGE <br />--�— <br />INTAKEBY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />SALES <br />ORKS <br />17 JM`^LOCAL <br />TAX CODE IS 3105 <br />