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i <br /> APPLICATIC% FOR CONSTRUCT' IN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT 0#:7'r <br /> BUILDING DEPARTMENT (( HFATING SYSTEM: )(GAS U ELECTRIC U J <br /> 259-8810 <br /> DEMOLITION COMBINATION I BUILDING XMECHANICAL Li PLUMBING SIGN <br /> OWNER MAIL ADDRESS CITY ZIP PHONE <br /> $�r�rs✓A� �8_l0/s r. �r. ��e�Tr Y1��•?3 X55- �/9.3>� <br /> TENANT MAIL ADDRESS C17Y ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTL,' MAIL ADDRESS CITY ZIP PHONE STATE LICENSE A <br /> -*1"2)E7 4Af,9-?L7_S�- <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE STATE LICENSE A <br /> �ORwA- .V&79 ),n/G /9q,.a -1T-sv AvE-• W LyAr^.- --'? — <br /> ;71,11,CONTRACTOR MAR ADDRESS CITY ZIP PHONE. STATE LICENSE A <br /> CONTRACT PRICE OF WORK <br /> DE RIBE WORK AND!s�ARE FOOTAGE INVOLVED CONTACT PERSON MONS NO <br /> 7 30e - 3iS <br /> I HEREBY CERTII'Y THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE W BUILD.NG APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTK)N OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIE51 WORK WILL BE COMPLE1 ED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TC iIVE <br /> LOT BLOCK OF — AUTHORITY T'1 VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAN'REGULATING CONSTRUCTION OR THE <br /> PERFOP.MANCE OF CONSTRUCTION.THAI I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> -- APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAXI D NUMBER CONTRACTORS LAV! 18.27 RCW AND 290.200 WAC <br /> .rvi o p j <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER <br /> PROJECT ADDRESS 130NAWRE DMF <br /> _ 1,1Sr, r,Illul.1rscll-Nsnm <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. _TYPE O.%EQUIPMENT FEE <br /> WATER CLOSET(TOILET) _A IrAIHNDLG UNITS—H.P. —�— <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <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(WOOD BURNING) ' A <br /> DRINKING FOUNTAIN --�— FIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS i GAS PIPING <br /> ROOF DRAINS—RAINLEADERS I EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ' <br /> I <br /> I ' <br /> I � <br /> I I <br /> SUB TOTAL $ _SUB TOTAL $ <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SIDE SETBACK PL AN CHE .K NUMBER 1EI RECEIPT N(1 <br /> 7 <br /> USE ZONE L07AREA V/a.ANT SITE FEES VALUATION FEE <br /> 0 YES 0 NO BUILDING ' <br /> TYPE a cDNsr NO OF STORIES ____ w aowrwwm, — - - <br /> B1Q1F PLUMBING i <br /> SIZE OF BLDG FIRE SPRINKLERS REO'0 BASEMENT MECHANICAL <br /> ❑ YES F] NO <br /> OCCUPANCY LOAD FIRE ALARM REG'0 HEIGHT LIMITATION ADDITIONAL PLAN CHECK I <br /> I <br /> OTHER <br /> REASON <br /> STATE BUILDING SURCHARGE <br /> INTAKE BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES <br /> DATE TAX CODE IS 31D5 TOTAL / <br />