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APPLICATI( V FOR CONSIThuu ; ON PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BASIC: HOL (C` _y No. ?V2. ) <br /> BUILDING DEPARTMENT HEATING SYSTEM: UGAS U ELECTRIC ❑ _ <br /> 259-8810 <br /> I DEMOLITION lx4XCOMBINATION I I BUILDING I I MECHANICAL i I PLUMBING SIGN <br /> ,WI:L II MAX AWHE55 CITY IIP PIKINE <br /> S .T.r_ .c>_ -m 1I0M'ESIN_C.,....237 ELM ST EVERETT WA 98203 258-1503 <br /> II NMI MAK ADDRESS CITY Zµ PHONE -- <br /> ARCHRECI OR DESIGNER MAK ADDRESS CITY ZIP PHONE <br /> i <br /> GENE RAL CONTRACTOR MAL ADDRESS CRY ZIP PHONE STATE LICENSE <br /> _$ELECT IiOMES. INC. 237 ELM ST EVERETT, WA 98203 258-1503 SELECHI110KN <br /> MECHANICAL CONTRACTOR MAL ADDRESS CITY IIP PHONE STATE LICENSE! <br /> PIUMBNG CONTRACTOR MAIL ADDRESS CITY IIP PWAE SIAM LICENSE <br /> CONTRACT PRICE OF WORK <br /> 40000 <br /> UESCRIAE WORK AND SOWAE FOOTAGE 04VOLVED CONTACT PERSON AND PHONE NO <br /> Randy 258-1503 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PnoroseO USE a DULLING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> SFR PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> II GAL DESCRIPIKA O PROPERIV ISNGWN BELOW/OR ATTACH IWOCOPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> Hanabrook DIV t{ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUC710N OR 1111 <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THD. <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCEL TAXI D NUMBLII APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RC NO 296200 WAC. <br /> Selec domes, IV4 <br /> ONSI RUCIIDN LOAN UNDER ADDHLSS.TELEPHONE NUTABlR <br /> xb � —9 <br /> PROJECT ADORES D <br /> S `✓ uN Tun <br /> wntr euswsslclNv Nr, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENTFEE <br /> WATER CLOSET(TOILET) I A/C—A/MNDLG UNITS—H.P <br /> BATHTUB 1 FORCED AIR SYSTEMS—B.T.U. M E.A. - <br /> LAVATORY(WASH BASIN) , UNIT HEATERS—B.T.U. M <br /> _ SHOWER ' CLOTHES DRYERS , - <br /> 1 KITCHEN SINK 8 DISP ; VENTILATION FAN , <br /> DISHWASHER I RANGE HOOD ---- <br /> LAUNDRY TRAY <br /> TRAY ----:-- <br /> WATERHEATER <br /> CLOT HLS WASIILH WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) —� <br /> DRINKING FOUNTAIN FIREPLACE INSERT — <br /> FLOOR DITALN HEAT PUMP ---- -- "' ;- - <br /> BACKFLOW PREVENTERS ; GAS PIPING - --" <br /> ROOF DRAINS—RAINLEADER$ I EXHAUST FAN - --r — <br /> SINK(SERVICE—BAR,ETC.) I <br /> I <br /> , <br /> SUB TOTAL f ; SUB TOTAL f <br /> PERMIT $ PERMIT f ' <br /> TOTALFEE f ' TOTAL FEE f �— <br /> FOR OFFICE USE ONLY: <br /> INOI75EIBAEII IIEAq 6E1&MK SIDE SETBACK p(AN CHCLK RFEE <br /> 2IRCF.IPINO <br /> �f � <br /> oF S 51� i(7 <br /> USL ZONE LOT AREA yy�p VACANT S/RE FEES VALUATION FEE <br /> 1"7 ✓ ?vU Fir YES CI NO <br /> IYR BUILDING O,CONSI NO OF STORIES 000~, ,�d w,N.�M R 9 6-84 <br /> (_j�y(. __f —_ ' PLUMBING ; <br /> 1,110,61, t FIVE SPRINKLERS RECD BASEMENT MECHANICAL. <br /> 450 S,cpqgr ao ❑ YES A N0 ' <br /> OCCUPANCY LORD FNE ALA.REDO HEIGHTLILRTATION ADDITIONAL PLAN CHECK <br /> A � <br /> Ai 0!A$p OTHER <br /> iJ <br /> STATE BUILDING SURCIWiGE <br /> WIM[eY J DBY CITY OF EVERETT Ih� <br /> LOCAL SALES WORKS <br /> DATE ,� 3 TAX CODE IS 3105 TOTAL <br />