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APPLICATI04b4' FOR CONSTRUCT1'-A PERMIT °"'" <br /> TO BE COMPLETED IN INK-PLEASE PRINT e <br /> c:HY of <br /> everett HEATINGSYSTEM: (p GAS 0ELECTRIC ❑ _ <br /> FO" BUILDING DEPARTMENT <br /> p <br /> 259-8810 <br /> H y DEMOLITION t COMBINATION l BUILDING 11 MECHANICAL PLUMBING I ; SIGN <br /> OWIIE MAR ADDRESS CITY' ZIP PHONE <br /> y ljaTr6-rnf_ Tx' E yDzon�,ln �. tq 04 qei?d Z. r ) 5-3y-a4VV <br /> K• n TENANT MAR AOaIE88 CT' ZIP PHONE <br /> NH ARCHITECT OR DESIGNER IMRAOORE56 CITY ZN PHONE <br /> .T.� .ml �4sz/I c A4nln� LIX, 4lATn, G/A 9�e33 ?2 2-172V <br /> M O E GENERAL CONTRACTOR MMLADORESS CITY ZIP PHONE IICENSEA <br /> C H o Te'Vrly r- lclul �9++nc its ouBry) TPU7YI I1 D 99 /1 <br /> L- MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/ <br /> N <br /> L'1. 0 <br /> _ <br /> zy PLUMBING CONTRACTOR MAR AaIRE89 CITY ZIP PHONE LICENSE/ <br /> H13 GLASSOFWORK <br /> [[[yyy ti X NEW ADDITIONl ALTERATION 0 REPAIR 0 DEMOLITION .I WOODSTOVFIFRPL INSERT BUILDING RELOCATION <br /> IJ z CONTACT PERSON AND PHONE <br /> LT' CONTRACT PRICE OF WORK <br /> Z Ij U7 DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> HOW ('q�•YA IX4A Il. 114 .S "'� 3 <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> BELOW <br /> S I 1 T! I APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DFSCRIPTKIN OF PpOPERT/IS OWI! 011 ATTACH FOURCOPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LOT _ BLOCK OF A4+Tab�cnC 171V 1 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOER NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL!AW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONb!RUCTION.THAT I AM AUTHORIZED BY THE ' <br /> OWNER OF THIS PROPERLY TO PERFORM THE WORK FORWHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298.200 WAC, <br /> SIGNATURE OF CONTIUCTOII OR AUTHORIZED AGENT DATE <br /> PROJECT ADDRESS -' <br /> 2 � I ��� 1]I,y,� C' ['. APPLICANTS CITY BUSINESS LICENSE NO AND BUSINESS NAME <br /> PLUMBING / F�IL.I/ `l C/ MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) - NC-AMNDLG UNITS-H.P. i <br /> BATHTUB ' ' FORCED AIR SYSTEMS-B.T.U. M E.A. _ <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> I - CLOTHES DRYERS <br /> SHOWER <br /> KITCHEN SINK d DISP .S VENTILATION FAN ' <br /> DISHWASHER <br /> _ RANGE HOOD <br /> ' <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE <br /> METAFIREPLACE d CHIMNEY D' 00 <br /> URINAL <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> —1� FLOOR DRAIN ' - HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; K GAS PIPING ' <br /> ROOF GRAINS-RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE-BAR,ETC.) ; I USIn - -20(nS 'OO <br /> 1 I <br /> 1 , ' <br /> I ' <br /> ' <br /> Ow SUBTOTAL S � SUBTOTAL $ ' M <br /> i��� PERMIT S T PERMIT <br /> TOTAL FEE $ (OS '0'a I TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SIDEPETBACK� PIANCHECK NUMBER FEE RE�TNO <br /> �v I 2� 3 <br /> USE ELOT AREA VACANT FEES VALUATION FEE <br /> / BUILDING <br /> T: TSAUOWAB[[ IYAfa WNST.AC1UAl wwmummn <br /> v- / PLUMBING (OS�OD <br /> SIZE OF BLD(!, - NO OF STORIES BIUIEMENT MECHANICAL (J ' OD <br /> 149"7 I- � d �7/F1(� <br /> OCCUPANCY LOAD RNK <br /> PE SPPlERS REOD HEgNT UMITA KIN ADDITIONAL PLAN CHUCK <br /> �.7 _ OTHER ' <br /> REASON FON SPRINKLERS <br /> STATE BUILDING SURCHARGE '6�J1 <br /> INTAKE BY PLANSAPPROVFO BY CITY OF EVERETT PUBLIC WORKS 67 1/(/ <br /> 9 rP�� TAX CODE IS 3105 TOTAL <br />