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APPLICATIC 1 FOR CONSTRUCT 3N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT cvrireTr <br />BUILDING DEPARTMENT HEATING SYSTEM: J GAS J ELECTRIC J JSprinkler <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Bob Withers Construction 21611 45th Ave. S.E., Bothll, WA 98021 481-4594 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CRY ZIP PHONE STATE LICENSER <br />Bob Withers Construction 21611 45th AVe.S.E., Bothell, WA 98021 481-4594 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br />Robinson Plumbing, Inc. 607 SE Ev Mall Way #26, Everett, WA 98208 355-6171 ROBINP*272C2 <br />CUSS OF WORK <br />X NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVF/FPPI INBCPT 01111 nlAln eel n Al <br />CONTRACT PRICE OF WORK $1175 • DD <br />CONTACT PERSON AND PHONE NO. <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Sprinkler System <br />P OPOSED USE OF BUILDING <br />SFR <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 />CON��.1T�RI.CTORS LAW 18.27 �RRCCCW�_AJN��D 296.200 WAC, A <br />LEGAL DESCRIPTION OF PROPERTY JSHOWN BELOW OR ATTACH FOUR COPIESI <br />LDT BLOCK of <br />PROJECT ADDRESS <br />1923 73rd Street S.E. <br />gNA11mE����'C M��/y�� <br />CITY KUSPIFSS I KTNST w <br />PLUMBIND <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />AIC—A HNDLG UNITS—H.P. <br />, <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />I <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />_ <br />CLOTHES DRYERS <br />, <br />KITCHEN SINK 8 DISP <br />; <br />VENTILATION FAN <br />I <br />DISHWASHER <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />I <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />' <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />I <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />I <br />_ <br />BACKFLOW PREVENTERS <br />I <br />GAS PIPING <br />_ <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUSTFAN <br />, <br />SINK (SERVICE —BAR, ETC.) <br />I <br />_ <br />' <br />I <br />I <br />) <br />I <br />SUB TOTAL $ <br />, <br />Ptnm., <br />$ <br />$ <br />I <br />PERMIT S <br />i <br />TOTAL FEE <br />$ <br />' <br />TOTAL FEE $ <br />' <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PUNCH CK <br />FEE _ <br />RECE IPi O <br />C3 <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />— - - — <br />-- - <br />TYPE OF LONiB ALLOWABLE <br />TYPE d CONSi ACTUALCf%UMNCY <br />clmur <br />NIl p UWuIIp UKnb <br />PLUMBING <br />I <br />SIZE OF BLDG <br />NO OF STOBIFS <br />BASEMENT <br />MECHANICAL <br />—~ <br />ADDITIONAL PLAN CHECK <br />' <br />OCCUPANCY LOAD FIRE SPRINKLERS REOD HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />SPRINKLER (9 Reads) <br />STATE BUILDING SURCHARGE <br />T <br />INTAKE BY <br />PLANS AW&F, BY <br />Gi (9 - <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />I <br />TOTAL <br />-2.a-�-99-- <br />