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APPLICATIOd FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: XGAS ❑ELECTRIC ❑ <br /> 259.8810 <br /> ❑ DEMOLITION ❑ COMBINATION BUILDING ❑MECHANIrAL ❑PLUMBING ❑ SIGN <br /> OWNERMAIL ADDRESS CITY ZIP PHONE U <br /> ()m, %nit-e s /4q/0 441 if7�'�t <br /> TENANT ✓ MAIL ADDRESS CITY TIP PHONE <br /> ARCnLHITLC'T_O_R'DESIGN^ERa MAIL ADDRESS CITY 21P PHONE <br /> �✓4�f.. <br /> GENERAL <br /> ,CONTRACTOR <br /> (, MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br /> IJWY✓K K-V Fi G[J Y[iG.Y OVM1 /Z40mts 1 <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br /> PLUMBING CONTRACTOR MAILADURESS CITY ZIP PHONE STATE LICENSE <br /> CONTRACT PRICE OF WORK <br /> DESCRIBE IVORK AND SWARE FOOTAGE INVOLVED f A� PE55O�!^l(D PHQQNE No _— <br /> de�J CmLa +-rI t VVGIA1OWOJP✓VAFIV <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PRpOPOBE_D QUBE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> /n 2lLW ra•l LGF �H 4� fame GC PROVISIONS OF LAWS ANC ORD VANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPE )SHOWN BELOW OR ATTACH TWO COPItl <br /> WORK WILL BE COMPLETED WITi- WHETHER SPECIFIED HEREIN OR <br /> LOT—� BLOCK OF / NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> TT//77 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> jl Gi Y,�! Q�I h "n n�� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THU <br /> I,I u a �J •�"�M'• L OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCEL TAX 1.0 NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �/�Ja^•. � D O)/_ O CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER <br /> PROJECT AOD ES yJ / <br /> BXKUT " <br /> r I M 1 V r{/ CRY MRNEy IK.EH6E Iq ,d[ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I A/C-AYHNDLG UNITS-H.P. I _ <br /> BATHTUB ' FORCED AIR SYSTEMS-B.TU. M E.A. ' <br /> �10'- LAVATORY(WASH BASIN) I UNIT HEATERS-B.T.U. M ; <br /> I SHOWER CLOTHES DRYERS <br /> I KITCHEN SINK 8 DISP _ / VENTILATION FAN <br /> / DISHWASHER I RANGE HOOD <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER I WOOD STOVE ; <br /> URINAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS07, 1 GAS PIPING <br /> ROOF DRAINS-RAINLEADERS i EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC.) ' <br /> I ' <br /> � I <br /> I , <br /> I <br /> I <br /> SUB TOTAL $ SUB TOTAL S <br /> PERMIT $ I PERMIT S I �) <br /> TOTAL FEE $ ' TOTAL FEE S <br /> FOR OFFICE USE ONLI: <br /> FOCHT SETBACK REAR SETBACK SIDE SETBACK PLAN CHECK NUMBER FEE RECE PTNO <br /> Z's, 75 �s_ Z .3G I <br /> USEZONE LOTAREA g� VACANTSITE FEES VALUATION FEE <br /> 2 L}y YES ❑ NO BUILDING <br /> Ti <br /> E OF CONST. NO.OF STORIES OLyGAM0AIBM�Cr AO OI PKLIMBINRi <br /> J 2 k PLUMBING <br /> 5f Q BLDG FIRE SPRINKLERS REOD BASEMENT I <br /> 5F t ❑ YES NO MECHANICAL n IY7r"7 <br /> .:a2 s �:anA v <br /> OCCUPANCY LOAD FIRE ALARM REO'0 HEIGHT LIMITATION ADDITIONAL PLAN CHECK <br /> Q T <br /> 2 OTHER <br /> gEA50N <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANSA7 DBY CITY OF EVERETT PUBLIC WORKS 71l iC�( <br /> LOCAL SALES <br /> DATE B� TAX CODE IS 3105 TOTAL <br /> r I _ <br />