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APPLICATIQ��7 FOR CONSTRUCT'��1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS 1�ELECTRIC ❑ <br /> 259-8810 <br /> -�---------------------------_._ __----�---------_____..___-------------�--------- <br /> ❑ DEMOLITION ❑ COMBINATiON �Q,BUILDING ❑MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWNEP MAILAUORE55 CITV ZIP PHONE <br /> �s��1tV �A.u��e�.�o,�7"�Auc 5E Eve�ZT 9B.Z08 3,s.3 - 7�{D�O <br /> TENANT MAII ADDRE55 CITV IIP PHON[ <br /> I n <br /> C /Y'6 0 LrP <br /> � � ARCH�T�ESIG� MAILADDRE55 CIN ZIP PHONE <br />;�: : .. �ix.. �Q+�I�e �laSt�32�� �TPor.�ib,JlLw ,q�.ri.:ik 9R�7I !0 9 - f3077 <br /> yt.t�3„ GENERALCONTRACTOR MAILADDRESS CITV �� ZIP PHONE STATEUCENSEp <br /> '}��'.'!:i —��U�17 C r <br /> e�,�U �,i ��- MECHANICALCONTRACTOR MqILADDRE55 CITV IIP PHON< STATEIICENSEN <br /> ,t�;�:{�;w.; � <br /> p � ( a ".�: . PLUMBINGCONTRACTOR MAILADDRE55 CITY ZIP PHONE STATELICENSER <br /> i� " � . , . v �J <br /> CONTRACT PRIG[O�(R� �� ���` <br /> /5 <br /> F.l <br /> I � � �ESCRIBE WORK AND SOUARE FOOTA E V LVED CONTACT PEflSON AND PHONE NO. <br /> { <br /> i vJ <br /> � • . G� �1�4���pAQi q.i <br />�� ����6 — i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSE USEOFBUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � <br /> LE�ALDE�SC�flIJPTIONOFPROPEfl�TY���SHO�W�NBELOWORATTACNTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or-ti—�— BLOCIr=-3L'�3'OF ,��4T O� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �jQO�WKu 1SMw/�� �S i y. 69 F7T O f �THER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> I �— 9,t OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I.O.Nl1MBER CONTRAC?ORS LAW 18.27 RCW AND 296.200 WAC. <br /> 3q7v - o - <br /> CONSTRUCTIONLOANLENDEP.ADOflE55.TELEPHONENUMBER ��� / � n��j /� J� <br /> A // J // <br /> /\� O RJ �r�I� ''� <br /> PROJECT ADDRESS o SiGN iUB�E U onte — <br /> 3 S� v O CITYBUSMESSUL[NSENO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TYPE Or E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C--A/HNDLG UNITS—H.P. , <br /> BATHTUB ; FORCED AIR SYSTEMS--B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS � <br /> KITC:IEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) � <br /> � DR�NKINCa FOUNTAIN i FIREPLACE INSERT ' <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOF DRAINS--RAINLEADE.RS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � � <br /> � , <br /> � , <br /> i , <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ � pERA71T $ � <br /> TOTAL FEE $ ' TOTAL FEE $ � <br /> FOR�FFICE USE ONLY: /��. 70 <br /> FRONTSETBACK. REARSETBACN�� l SIDESETBFC� PLANCMEGCNUM E�, FE��� � PECE�%jCL'L <br /> �J/� ' � �l� UlY <br /> l..�`� !!� <br /> U ZONF.� LOT APEA VACr1NT SITE FEES VALUATION FEE <br /> v ❑ YES o No BUILDING �s. oo a � � o <br /> ttPEOFLON51. NO.OFSTORIES atuvu+cY uoormv[LUNGUNrtS � <br /> _ J °�°�� PLUMBING OO <br /> i <br /> SIZEOFB 4DG� FIRESPRINNlER5RE0'D BASEMENT MECHANICAL ��i <br /> y2� 5/` GViM�. � <br /> cvO S Gan p ❑ YES Lr/NO � O(� <br /> OCCUPANCY LOAD FIRE ALARM REO'D HEIGHT LIMITATIO j ADDITIONAL PLAN CHECK � � <br /> 1J�A_ D OTHER � <br /> REASON <br /> STATEBWLDINGSURCHARGE � i��1 <br /> INTqNE BY PLANSAPPROVED BY CITY OF EVERETT PUBLIC WORKS 1 <br /> �}-� LOCALSALES � <br /> DATE � 3 g5 TAX CODE IS 3105 T�TA� ,3iS ;fJ <br />