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APPLICATION FOR CONSTRUCTtJN PERMIT <br /> rnn t�P.n•.�.1 TO BE COMPLETED IN INK—PLEASE PRINT <br /> CITY Gr <br /> everett HEATING SYSTEM: ®GAS U ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 2598810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL ❑PLUMBING SIGN <br /> OWNERL MAIL A DRESS CITY ZIP PHONE' <br /> TENANT MA)L ADDRESS CITY ZIP PHONE <br /> oApt I <br /> ARCHITECT ORDESIONEMAIL ADOR �'- oaa ''IJ?Luhz 9yoc�� PHONE� Cr p/ � Q• ];1 c?n17i <br /> I <br /> GENERAL CONTRACTOR ADDRESS -- <br /> 7 �� �11 c. CITY I� j? � PNONELICENSE <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE B <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE III <br /> CLASS OF WORK <br /> N':W ADDITION ALTERATION REPAIR f DEMOLITION WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATIIO�N <br /> �• UD CONTACT PERSONA�ND�P,� ENO. �M?s /•-093' 740G�7 <br /> CONTRACT PRICE OF WORK /�I/ ' •"" �J� �J <br /> DESCRIBE WORKAND ARE FOOTAGE INVOLVED /JAS /'� •//�rtC'I1 <br /> PRDP sEp usE QF BmL a /: I EREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> {� ct� , ac0•It APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DE IPTKJN OF PNOPERi,1 HOVM BELOW OR ATTACH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �/11 <br /> !1 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT_ 44 BLOCK OF A�,.it/' / NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> t2� AUTHORITY TO VIOLATE W CANCEL THE PROVISIONS OF ANY <br /> q, l �-j2 �/ � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> [�'_jV_� a� — OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> 4jGV APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATURE OF CONTRACT I A� O AyRN C DATE <br /> PROJECT AGGRESS <br /> e7 ^ ? - 6•0 APPLICANTS',96 BUSINESS LICENSE NO.AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) / ArC—A/HNDLG UNITS—H.P. I <br /> BATHTUB S FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) / UNIT HEATERS—B.T.U. M i <br /> SHOWER / CLOTHES DRYERS ' <br /> KITCHEN SINK 6 DISP VENTILATION FAN ' <br /> / DISHWASHER ' RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> / CLOTHES WASHER I WOOD STOVE ) <br /> URINAL ' / METAL FIREPLACE B CHIMNEY 30' a <br /> DRINKING FOUNTAIN • FIREPLACE INSERT <br /> / FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) o✓ �*^- `r/- d ' n <br /> I ' <br /> I ' <br /> I <br /> I ' <br /> SUB TOTAL $ - — SUB TOTAL $ <br /> PERMIT $ I PERMIT $ <br /> TOTAL FEE $ '� TCTAL FEE $ 170 " <br /> FOR OFFICE USE ONLY: _ 1 CA K w �D P <br /> FRONTSETBACK REARSETBACK SIDE SETS?CK PLAN CHECK NUMBERE.33O�P36^20RECEIP NO <br /> D ' o S r' 3 <br /> / �V <br /> USEZONE 77 LOTA UATION A/REA VACANT SITE EES VALFEE <br /> _ BUILDING 20 t �� - <br /> IYPF Of CONIS ALLOWABLE TYPEOFC NSIACIUAL =~ ]KIMMILM MITE '—" i '- <br /> 1,' PLUMBING do <br /> O <br /> SIZEOF BLDG NO OF STORIES BASEMENTI 1 <br /> MECHANICAL <br /> / Ala3 - <br /> OCCUPANCYLOAD FIRE SPRINKLERS REDO HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> Al OTHER <br /> REASON FOR SPRINKLERS I <br /> STATE BUILDING SURCHARGE ' <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS O i d c <br /> LOCAL SALES T <br /> '� 7 -7& TAX CODE IS 3105 TOTAL 117 <br />