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APPLICI�TIC'7 FAR CONSTRUCT'�lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 2�i9•8810 <br /> ❑ DEMOLITION �7 COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING � SIGN <br /> OWNEF ^ � MAILADDflESS CITY ZIP PMONE — <br /> r <br /> TENANT M4ILADDRESS CITV ZIP PHONE <br /> ��4�eSiw�LAW� 11014 1`I„ /�VE'�i. �v�C�r � !h `iK��^"S 33`f-3b2.5; <br /> ARCHITECTORDESIGNEF MAILADOFESS CIN 21P PHONE <br /> GENERALCONTRACTOH MAIIADDRE55 CITV ZIP PHONE STATELICENSEN <br /> ADc�u� nl�.l t4���-i� �A�c %}i�l Mnz�sv��-u: ���z„ ��z-35zy APn�4.��. ckiSs <br /> MECHANICALCONTRRCTOR MAI:AJOf1E55 CITY ZIP PHONE STATELICENSEI <br /> PLUMBINGCONTFRCTOR MAILADORESS CITV ZIP PMONE STATELICENSEt <br /> CONTRACT PRICE OF WORK <br /> - 5Z..5�i�J <br /> SCHIBEWORKANDS(]UAREFOOTAGEINVOLVED CONTACiPEfl50NANDPHONENO��. �� <br /> �v�.:, z 5 cv� - �3vr.�� Sc,�e� ,�— <br /> C�Vi+.��.1 Z L='M�CLSi L.nl — 1`I W (oSZ 3`6'7_.�{ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> FROPOSEDUSEOFBUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCRIPTIONOFPROPERNISHOWNBELOWORATTACHTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�xK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OF LOCAL LAW REGULATING CONSTRUCTION OR THF <br /> PERFORMANCE OF CUNSTRUCTION.THAT!AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANU I COMPLY WITH THE STATE <br /> PARCEL TAX I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENDEH.AODRE55.TELEPHONE NUMBER <br /> X S�n iv-2a-95� <br /> - PROJECTADDRESS S�GNAtUPE oere _ <br /> � CiTY BIISwESS uCENSE NO <br /> PLUMBING MECHANICAL <br /> , NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF Ei'.:IIPMENT FE�_ <br /> WATER CLOSET(TOILET) � AI�A/HNDLG UNITS�H.P. _�_ , <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' _ <br /> LAVP.TORY(WASH BASIN) i UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHESDRYERS ' <br /> KITCHEN SINK&DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD ' _ <br /> LAUNDRYTRAY ; WATERHEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PR[VENTERS ; GAS PIPING � <br /> ROOF DRA�NS--RAINLEAUERS � EXHAUST FAN ' <br />� SINK(SERVICE—BAR,ETC.) � � <br /> � <br /> � ' <br /> i <br /> � <br /> I ' <br /> � � <br /> SUB TOTAL $ ' SUB TOTAL S ' <br /> PERMIT $ PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FAONTSETBACK /, REA TBAGI( /, S�DESETBALK PLANCHECKN�ON�B�<' FEE /� 'l RECEIPTNO. <br /> // / �j; U <br /> �( �l <br /> USE20NE LOTAREA VALANTSITE FEES VALUATION FEE <br /> � ❑ YES ❑ NO gUILDING ' <br /> TYPEOF;ONST NO.OFSTORIES ottUPnxtr NO.OfDWEIIiNGUNnS . � <br /> cxauv PLUMBING i <br /> SIZEOFBL�G. FIRESPRINNLERSREO'D BASEMENT � <br /> MECHANICAL ' <br /> ❑ YES ❑ NO � <br /> OCCUPANCY LOAD FIRE ALARM FEO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> i <br /> OTHER i <br /> REASON � — <br /> STATE BUILDING SURCHARGE <br /> MTAKE BV PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS i II <br /> ,,,1�1/� LOCAL SALES � _ <br /> DATE (p Cf� TAX CUDE IS 3105 � rora� ; <br />