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APPLICATIC- 1 FOR CONSTRUCTFWN! PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT .-%G'f <br /> HEATING SYSTEM: GAS J ELECTRIC _� <br /> BUILDING DFOARTMENT J_ -- <br /> 2598810 <br /> DEMOLITION I COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNCR MAIL ADDREES CITY ZIP PHONE <br /> f�ycot /�oof 10 a ax 9bin07 efo3 -- <br /> TENANT MAR ADDRESS CITY ZIP PHONE <br /> ARCHITECT OR DESIGNdR MAR ADDRESS CITY ZIP PHONE <br /> eac <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br /> 4�0MECHANICAL CONTRACTOR MAR ADDRESS CITY ZIP PHONE STATE LICENSE <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE If <br /> CONTRACT PRICE OF WORK <br /> DE RISE WORK AND SQUARE FOOTA INVOLVED CONTAf"Ij'ERSON AND PHONE N <br /> _ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> f��.-/T, t PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL OESCRIPTIONOFPROPE (SHOWN BELOW OR ATTACH TWOCCPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �" n�1 <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT 40 BLOCK OF �RJ2QA5 �1 ✓� 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 /> PARCEL TAXI D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296 200 WAC. <br /> ?/3,6--eov-/) <br /> CONSIRUCIKY1 LOAN LENDER,ADDRESS,TELEPHONE NUMBER <br /> L�tu V' �'u-1uL,L �• 7 �� <br /> PROJECT ADDRESS <br /> - 7 T ✓e - 9�' ' 3 CiTYBUSMSSLCLxSFND <br /> _ PLUMBING MECHANICAL <br /> ,JO. TYPE OF FIXTURE OR ITEM FEE NO, TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) I AIC-AIHNDLG UNITS-H.P, <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS ' <br /> / KITCHEN SINK 6 DISP VENTILATION FAN I <br /> DISHWASHER - RANGE HOOD ' <br /> LAUNDRY TRAY ( ; - WATER HEATER ' <br /> CLOTHES WASHER I WOOD STOVE ' <br /> URINAL METALFIREPLACE(WOOD BURNING) 3 7 ' Ov <br /> DRINKING FOUNTAIN I FIREPLACE INSERT I <br /> FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS - GAS PIPING ' <br /> ROOF DRAINS-RAINLEADERS I EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) I , <br /> I <br /> v ; <br /> SUBTOTAL $ / ;UV SUBTOTAL <br /> PERMIT $ PERMIT $ <br /> TOTALFEE $ TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> IRONf SETBACK, RLAP VL IRn<n SIDE SETBACK / PLAN GHECKN BER FEF, -77 RECEIPT NO <br /> U E ZONE LOT AREA [aG_ VACANT SITE FEES L/Jn VALUATION FEE <br /> VES NO BUILDING ZZ ,_`I S• �O 77 ) w <br /> TYPE Of CONST NO OF STORIES 1[C,.rwc. xo aowlwxc lAiT3 i00 <br /> PLUMBING <br /> SyE OF BLDG FIRE SPRINKLERS REOD BASEMENT MECHANICAL :D0 <br /> 3 ¢p1 Ste f- J f YES NO p n <br /> OCBpW.vu D FIRE ALA M REOD XEKiHT lIM TAT ADDITIONAL PLAN CHECK <br /> Al"' OTHER ID i <br /> REASON <br /> STATE BUILOINO SURCHARGE <br /> INTAKE BY PLANS APPROVED By CITY OF EVERETT PUBLIC WORKS <br /> .\J Id- LOCAL SALES 7� <br /> DATF Z S ZJ TAX CODE IS 3105 TOTAL �'�? <br />