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APPLICATIOBJ FOR CONSTRUCT4JN PERMIT L <br /> the Everyreen TO BE COMPLETED IN INK—PLEASE P91NT <br /> CITY OF <br /> I've rett HEATWCi SYSTEM: GAS ❑ELECTRIC O _ <br /> BUILDING DEPART:1ENT _ <br /> 25.-8810 <br /> ❑ DEMOLITION COMBINATION A BUILDING MECHANICAL ❑PLUMBING ❑ SIGN <br /> O I R V /^b AIL ADDRES� 'LIL / /ntY',L fix/ vH:EIEE <br /> 1 XFGCAa�2 >S�_y��L <br /> TENANT MAIL ADDRESS CITY �� ZIP <br /> PNCNE <br /> ARCHITECT OR OESIG���� `A /AQ R NJ� C � 21P PHONE <br /> D nW C -DRES„/ I NE <br /> G�CONTRACTOR MAd ADDRESS CITY ZIP PHONE LICENSER <br /> MECHANICAL ONTRACTOR MAR ADORESS CITY ZIP PHONE LICENSE R <br /> PLUMBINGCONTRACTOA MAIL ADOSESS CITY ZIP PHONE LICENSER <br /> S OF WORK <br /> f NEW (7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION L] WOODSTOVEIFRPL INSERT ❑ BUILDING RELOCATION <br /> CONTACT PERSON AND PHONE NO. <br /> CONTRACT PRICE OF WORK <br /> �Om SOUARF FOOTAG INVOLVED <br /> PROPOSED USE OF BUIL NG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> / ?/W <br /> l /�•� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORgECT.ALL <br /> L Al.DES4tRIPTION OF PROPERTY(SHOWN BELOW OR TTACH WACOPIESI N� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> BLOCK of <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> L 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 CONSTRUCTION OR THE <br /> /'/ PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> �jyq/ � 130 flimbko OWNER OF mis PROPERTY TO PERFORM THE WORK FOR WHICH <br /> /--�-' - APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNATURE OF CONTRAC ED AGENT DATE <br /> X <br /> PROTECT ADDRESS <br /> APPL S TTY SI E UCENNO.ANODUSINESSNAM <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE 110. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I AIC-A/HNDLG UNITS-H.P. <br /> BATHTUB - '- FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) - I- UNIT HEATERS-B.T.U. M <br /> SHOWER_ _ '- / CLOTHES DRYERS <br /> / KITCHEN SINK&DISP ; 41 VENTILATION FAN <br /> f DISHWASHER '-- / RANGE HOOD <br /> _ IAUNDRV TRAY ; WATER HEATER I <br /> CLOTHES WASHER I- WOOD STOVE <br /> URINAL <br /> METAL FIREPLACE B CHIMNEY I <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.) <br /> I <br /> I <br /> I <br /> SUB TOTAL $ ;— SUB TOTAL S ' — <br /> _PERMIT $ PERMIT S , <br /> TOTAL FEE $ TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SIF-BACN REAR SETBACK SIDE 6ETBACK PLAN CHECK NUMBER FE RECEIPT NO. <br /> 2U� L/ �/ C7 / <br /> USE Z/INE LOT AREA Z VACANT SITE FEES VALUATION FEE T_ <br /> I <br /> TYPE DF CONTS NtYP <br /> LCWABIE f pCONST ACEWBUILDING amMAA[r Aa gpMUlMwn — <br /> c+wr PLUMBING <br /> SIZE OF BL14,11) DG NO OF STORIES BASEMENT <br /> aw <br /> lSa. -,` MECHANICAL <br /> 412 mo 7U I <br /> OCCUPANCY LOAD FIRE SPRNKLERS NEO D FOHEIGyHn�NMAJ10F1 ADDITIONAL PLAN CHECK <br /> !A 7 <br /> "EAVAR SPRINKLERS NO OTHER <br /> STATE BUILDING SURCHARGE ,[ ' <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS n <br /> J o /jzLOCAL SALES — Ioz) <br /> TAX CODE IS 3105 TOTAL <br /> /' Iia <br />