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�_ _ a.`..� . _� <br /> � <br /> � <br /> APPLIC�►TIC _� �O� CONSTRUC7 _JRi P�RMIT � � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRII:T �.✓�„F/,E,-.� <br /> �J_"' ;� <br /> � <br /> � � <br /> BUILDING DEPARTMENT HEATING SYSTEM: CN�GAS ❑ELECTRIC ❑ <br /> 259-8810 �y <br /> DEMOLITION COMBINRTION ✓BUILDING MECHANICAL PLUMBING SIGN �+ <br /> OWNER � IAAiI ADDRE55 CITY ZIP PHONE . � <br /> pALLY E-IDt�iE�, I NU. 3?�f0 EA`i(,AY.� AVE E , g�a., �i81�'L 328•���U � <br /> TENAI�T MAI�ADDPE' CI�V ZIP pMONE � <br /> I <br /> ARCHITECTOqDE51GNEq 61AILADDRf',i CITY ZIP PHONE �' <br /> r <br /> _ � <br /> GENERALCONTRACTOq MAILAD�RESS CITY 21P PHONE STATELICENSE+1 <br /> SAME ii� A�t�/� �e <br /> �., <br /> 1dECHANICA�CONTRACTOR MFILADOFESS G�V ZIP PMONE STFTELICENSEp �� <br /> PLUMBING CONTFACTOR MAIL A�DRESS CITY Zip PHONE STATE LICENSE q <br /> CLASS OF WORK <br /> :✓NEW ��. ' ADDITION . ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> GONTACT PEFSON AND PNONE N0. <br /> CONTRACTPRICEOrWOFK ���,tZ,`� �;YLr�l�12, 25'G�90�g <br /> OESCRIBE WOBK AND SOUARE FOOTAGE INVOWED <br /> cor��T2ur��F�r+�l�����rl���E- 1�52 �-1���-Y �-�Uhl�t��.' �=zS ���lU <br /> PROPOSEDUSEOFBUILDINfi I HEREBY CERTIFY THAT I 4AVE READ AND EXAMINED THIS <br /> �� C� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> LEGALDESCRIFTIONOFPROPERTY�SHOWNBELOWORATTFCHFOURGOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNWGTHISTYPEOF G <br /> �1.�^ p�- � WORK ':"lL BE COMPLETED WITH WH[THEF SPECIPIED HEREIN Oli � <br /> LOT � BLOCN OF � IG PF-C��( � � NOT. THE �RANTING OF A PERMIT DOES WOT PRES�IME TO GNE � <br /> �("r-��� 7� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OH LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � OWNEF OF THIS PROPEflTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STAT� <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �/ / b <br /> �''����.��,K:"l. . /I.�QG��l . (/27/ / �' C <br /> PROJECTAD�RE55 ,ic�iniunc onrz � . <br /> _ 'L-� "� -�}�11� �[.A�E — -- r; <br /> CIiV pU51NE55liC[GSE f:0 <br /> PLUMBING MECHANICAL �� <br /> NO. TYPE OF HXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE i� <br /> WATER CLOSET(TOILET) A!C—NHNDLG UNITS—H.P, u' <br /> BATHTUB � ; FORCED AIR SYSTEMS—B.T.U. M E.P.. <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M - <br /> SHOWER � CLOTHES DRYERS � � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN Y� <br /> DISHWA:iHER � RANGEFIOOD � � <br /> — ci <br /> LAUNDRYTRAY ; WATER HEATER <br /> CLOTIiES WASHER WOOD STOVE ; <br /> _ URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DP:�iN HEAT PUMP <br /> BACKFL0�4� PHEVENTEFiS GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVI:E—BAR, ETC.) ; <br /> � ; <br /> � , <br /> � ; <br /> SUB TOTAL S SUB TOTAL 5 <br /> PER�41T $ � PERMIT S I <br /> TOTAL FEE S ; TOTAL FEe $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACK SIDESETBACK PLANCHECKNUlAB° FEE FECEIPTNO. <br /> `�O' Ye�' si� Lf4N 5 ' �/,�� 3�' � ��51�� <br /> USEZUNE LOTAREA VACANTSITE FEES VALUATION FEE <br /> J BUILDING $'� ; � <br /> TYPEOFWNiS.ALLOWABLE i"PEOFCOtISTACiIIAL aCuvnr�tr uOOFON'FluxGUNiR i <br /> _� �_� p� I PLUM0ING i <br /> SIZEo�BLDG NO.OFSTORIES BASEMENT � <br /> I�7�31 SF'f MECHANICAL � <br /> 3Z S R2 2 �� <br /> OCCl1PANCY l � FIRE SPRNKLERS REO'D MEIGHT LIMITATION ADDITIONAL PLAN CHECK � <br /> fF- n�� �z ' -��. � pGN /D � <br /> � REASON FO SPi11NKLERS <br /> STATE BUILDING SURCHARGE �� <br /> INTAKEBV PLANSAPP�lOVEDBY CITY OF EVERETT PUBLIC WOR'(S LU� <br /> J T� LOCAL SALES � <br /> I �a�s-�� TAX CODE IS 3105 TOTAL ���2 /��v� <br />