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APPLICATICA FOR CONSTRUCT' )N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATINGSYSTEM: ❑GAS UELECTRIC U___ <br />259-8810 <br />DEMOLITION I i COMBINATION I I BUILDING LI MECHANICAL I I PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Ce°: and liona ManfLnn� /520-63rtd ff SF i A+ j48 44�/(L <br />TENANT MAIL ADDR CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />CITY ZIP PHDNE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE) <br />...�-..^...-^-­­..,..., ­1 woncw CITY ZIP PHONE ./7J�� STATE LICEII$F9 <br />PLUMBING CONTRACTOR MAIL ADDRESSCITY ZIP PN9NE $i��LON$EA <br />CONTRACT TRICE OF WORK <br />/OA DOD. OO 1 �� <br />DESCRIBE WOPK AND SOUARE FOOTAGE INVOLVED <br />JG— gamT R/4 <br />CONTACT PERSON AND PHONE NO <br />idc_c�eef_ t� 3319=9262 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITu THE STATE <br />ORS LAW 18.27 RCW AND 296.200 WAC. <br />2x,-.! / � <br />PROPOSED USE OF BUILDING <br />l GALD SCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH TWOCOPIES)) <br />LOT If d BLOCK —gOF Re1'eRZ" #aj AtV 2 <br />BLK 00 IJ-0/ <br />9 <br />PARCELTAXID NUMBER <br />3929-009-00/-0/0/ <br />CONSTRUCTION LOAN LENDER. ADDRESS. TEIEPHONENUMBSR <br />PROJECT ADDRESS <br />sHAfu:."' wTE <br />cmeusw[As Ixc,.v Nn <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A,C-AIHNDLG UNITS-H.P. <br />I <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />I <br />LAVATORY ( WASH BASIN; <br />, <br />UNIT HEATERS-B.T.U. M <br />I <br />SHOWER <br />' <br />CLOTHES DRYERS <br />�- <br />KITCHEN SINK 8 DISP <br />; <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGEHOOD <br />, <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />r <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />, <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />, <br />SACKFLOW PREVENTERS <br />I <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />I <br />EXHAUST FAN <br />I <br />SINK (SERVICE -BAR, ETC.) <br />, <br />I <br />; <br />' <br />I <br />SUB TOTAL $ <br />SUB TOTAL $ <br />; <br />_ PERMIT $ <br />PERMIT $ <br />TOTALFEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACIy <br />/ <br />REAF SETBACK <br />SIDE SETBACK <br />PLAN CHEC NUMBS <br />�76 <br />FEE <br />RECEIPT NO <br />USEZONI' ..77 <br />9 <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />'VALUATION <br />FEE <br />BUILDING <br />3 Z <br />-- <br />i <br />TYPE DI CONSi. <br />NO OF STORIES <br />Of[I/AKCY <br />rodorrtunp uAln <br />PLUMBING <br />SIZE OF BLDG <br />s <br />FIRE SPRINKLERS REO'D <br />BASEMENT <br />n 1N <br />YES - <br />MECHANICAL <br />�- <br />ADDITIONAL PLAN CHECK <br />, <br />OCCUPANC' LOAD <br />rFIREALARM REOD <br />HEIGHT LIMITATI <br />REASON <br />STATE BUILDING SURCHARGE <br />; <br />INTAKE BY <br />PLANS APPROVED BY <br />GAT I: <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />I <br />TOTAL <br />-71� <br />