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APPLICATIC I FOR CONSTRUCT IN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> 4:77- <br /> BUILDING DEPARTMENT �_ JING SYSTEM: 'UAS I ELECTRIC _I_- <br /> 259.8810 <br /> [1) DEMOLITION I i COMBINATION I BUILDING MECHANICAL II PLUMBING I 1 SIGN <br /> OWNER 7 MAIL ADDRESS CITY ZIP PHONE <br /> 46elnA2V �9/ il' lio?5 /k 5.6 >!L2Lr 9fd&3 /dig <br /> TENANT MAIL ADDRESS CITY ZIP PHONE <br /> ARCHITECT OR OESIONEI MAILADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> �U)nfA i <br /> MECHANICALC IHACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE I <br /> CONTRACT PRICE OF RN <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO <br /> I - Q <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE O UILDINc dellAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW QR,ATTACH TNCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT BLOCK FN((<,'z&c" NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> '? AUTIICRITY 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 /> � <br /> PARCEL TA% UM�BE7R ` APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTFl ORS�AW 18.27 PIC 296.200 WAC. <br /> CONSTRUCTION LOAN LENDER,ADDRESS.TELEPHONE NUMBER / <br /> PROJECT ADDRESS T�tr �p . T � s �• .-'J� <br /> DATE <br /> b !Iel <br /> - <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF OUIPMENT FEE <br /> WATER CLOSET(TOILET) _ AIC—AIHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. I <br /> LAVATORY(WASH BASIN) I UNIT HEATERS—B.T.U. M I <br /> SHOWER CLOTHES DRYERS , <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN �– <br /> DISHWASHERI _ RANGE HOOD —�— <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE -� <br /> I <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN , FIREPLACE INSERT ; - <br /> FLOOR DRAIN HEAT PUMP , <br /> OACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS I EXHAUST FAN , <br /> SINK(SERVICE—BAR.ETC.) ! , <br /> I � <br /> I <br /> SUB TOTAL $ ' SUB TOTAL $ <br /> PERMIT $ I PERMIT $ ' <br /> 7OTALFEE $ TOTALFEE $ I <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK , FEAR SETBACK SIDE SETBACK f PUN CH Ck UMBER FE RECEIPT NO <br /> 7-C3 �✓i'E�' z <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> I YES F, NO BUILDING �S ' <br /> TYPE DF LINISI NO.OF STORIES MCUI ITT9 MIT INS UMTS <br /> )V3 IT PLUMBING ) <br /> S12C OF toSit ±.f.0CLARE SPRINKLERS RECTO BASEMEN? <br /> SP AAOV YES /p MECHANICAL <br /> WJ <br /> OCCUPANCY LOAD FIRE ALARM REDD HEIGHT LIMIT ONN ADDITIONAL PLAN CHECK /S <br /> I L7 OTHER .. I v <br />� REASON I <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PARI IC WORKS <br /> J44- LOCAL SALES <br /> DATE TAX CODE IS 3105 TOTAL iJ <br /> L I <br />