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H30F <br />J, pm <br />6 f APPLICATIOd <br />FOR CONSTRUCI.ON <br />PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE <br />PRINT <br />HEATING SYSTEI.1: U GAS <br />&ELECTRIC ❑ —_ <br />BUILDING DEPARTMENT <br />259.8810 <br />`.. <br />DEMOLITION <br />BUILDING <br />XMECHANICAL�E <br />PLUMBING SIGN y <br />M^ACOMBINATION <br />Al <br />`j <br />;;;,Fe,rE <br />s vl PAM I)zw <br />E SOS _74 <br />ST SE <br />98203 <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />S A-rnf-- <br />ARCHITECTORDESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />GENERAL CONTRACTOR <br />MAILADDRESS <br />CRY <br />ZIP PHONE <br />STATE LICENSE <br />&AA07FFActS 14fOT110- <br />PD box ?Cfi <br />&IOMrWFAU-5 <br />q?PL - 69F4,555 GOIJIPH101MA <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CRY <br />ZIP PHONE <br />STATE LICENSE <br />SAYTAC AS <br />AgaVf- <br />PLUM13INGCONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LICENSE( <br />CLASS OF WORK <br />V NEW . ADDITION <br />ALTERATION <br />REPAIR DEMOLITION <br />WOODSTOVE/FRPL INSERT UUILDING RELOCATION <br />S <br />c: 1 ✓ <br />i <br />- —' <br />CONTRACT PRICE OF WORK <br />COHTACIPERSON YMOIV hl AND PHONE NO 1 - 65 <br />95 <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />nl tt ivmr> <br />(xo 51a Fr <br />PROPOSED USE OF BUILDING <br />S I EAJc u <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 WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW ND 296.200 WAC. <br />x/ f�- ."� 3/%3 z9�- <br />LEGAL DESCRIPTION Of PROPERTY (SHOWN BELOW OR ATTACH FDIIH COPIESI <br />LOT BLOCK OF <br />_ <br />. PROTECT ADDRESS <br />Soft J 5E F J <br />ts2o 3 <br />SKWIAI._ O`•" <br />CITY( $MB9lKLIK( <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLG UNITS—H.P. <br />_ <br />BATHTUB <br />FORCED AIR SYBTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK 8 D!SP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRYTRAY <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />i <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />' <br />I <br />I <br />I <br />I <br />SUB TOTAL <br />f <br />SUB TOTAL <br />PERMIT <br />S <br />PERMIT $ <br />/ 1 <br />TOTALFEE <br />$ <br />TOTALFEE S <br />FOR OFFICE USE ONLY: <br />FROM SETBACK <br />REAR SETBACK <br />SIDE SETBAF• <br />PLANC yxNUTABER <br />6'a 7C <br />III <br />RECE IPT NO <br />USE ZONE <br />LOT AREA <br />I VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />TYPE OT CENTS AUOWASLF <br />TYPE Of CMST ACIUAI <br />a y <br />W°'' <br />WWI" tWt 's-- <br />' <br />SME OF BLDG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />/3] <br />i <br />--� <br />ADDITIONAL PLAN CHECK <br />OCCUPANCYLOAD FIRE. SPRNKLERS REDO <br />REASON FM SPRINKLERS <br />INTAKE ev PUNS APrnov[u nv <br />HECHT LIMITATION <br />_ <br />CITY OF EVER ETT <br />LOCAL SALES <br />TAX CODE IS 31D5 <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />7 S do <br />