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36,tr 3"AM <br />APPLICATIC61 FOR CONSTRUCT" N PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT , <br />BUILDING DEPARTMENT HEATING SYSTEM .J GAS J ELECTRIC U __ <br />259-8810 <br />DEMOLITION COMBINATION 1 BUILDING i 1 MECHANICAL ❑ PLUMBING L 1 SIGN <br />OWNE <br />MAR ADORES& <br />CITY <br />ZIP <br />PNONE <br />, 4LwF4+o <br />�uLcic �D•IZoxs3S4� <br />96`/S� <br />Ca06 <br />9729 <br />TENANT <br />MAR ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR <br />MAR ADORFSS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSEE <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED , <br />CONTACT PERSON AND PHONE NO <br />ja <br />aa4 <br />36` -9729 <br />On C, <br />—Z <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES( <br />NOT. THE GRAI'TING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOt BLOCK OF <br />AUTHORITY TJ 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 />-- <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 AND 296.200 WAC. <br />X <br />SKINATu., u�U <br />PARCEL TAX I D NUMBER <br />CONSTR T LOANIT-4DER. ADDRESS. TELEPHONE NUMBER <br />DO/ 3 OOID/ <br />PROJECT ADDRESS % � _ <br />/a3 3 v �S• C <br />S7 <br />Pry RWM[SSlglha qo <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />CLOSET (TOILET) <br />I <br />A/C-AIHNDLG UNITS-H.P. <br />, <br />_WATER <br />BATHTUB <br />' <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />, <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />' <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK IS DISP <br />i <br />VENTILATION FAN - <br />DISHWASHER <br />I <br />RANGE HOOD - <br />' <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />, <br />FIREPLACE INSERT <br />) <br />FLOOR GRAIN <br />1 <br />HEAT PUMP - <br />' <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR, ETC.) <br />' <br />, <br />, <br />SUB TOTAL $ <br />; <br />SUB TOTAL S <br />PERMIT S <br />r <br />PERMIT $ <br />TOTALFEE S <br />' <br />TOTAL FEE $ <br />' <br />rvn yr , w� v <br />FA SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK <br />rll <br />RFCCIPT NO <br />��77U.MTBE�(J <br />v�I U <br />— <br />USEZCNE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— <br />QQ <br />�� 'V o <br />' <br />YES Fl NO <br />TYPE OF CONST <br />NO OF STORIES <br />p(WPu[r <br />No p vMlllw imas <br />'.wo <br />PLUMBING <br />SIZE OF BLDG <br />FIRE SPRINKLEFTS REGO <br />BASEMENT <br />MECHANICAL <br />' <br />❑ YES 0 NO <br />ADDITIONAL PLAN CHECK <br />I <br />ZZEUPAN:YLOAD <br />FIRE ALARM REDD <br />HEKIHTLMITATKX! <br />, <br />OTHER <br />REASON <br />STATE BUILDING :i..." ;HARGE <br />INTAKE BY PLANS APPROVED By CITY OF EVERETT <br />PUBLIC WORKS <br />i <br />LOCAL SALES <br />S b <br />TAX CODE IS 0105 <br />TOTAL <br />33 ; <br />DATE <br />