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E <br />APPLICATIG_J FOR CONSTRUCT. JIN PERMIT L'VL'TL'1I <br />the EI,,,,N,eer, TO BE COMPLETED IN INK —PLEASE PRINT <br />CITY " <br />everett BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS dELECTRIC ❑ <br />- <br />259-8810 <br />DEMOLITION ACOMBINATION BUILDING MECHANICAL PLUMBING SIGN <br />O"Fll I+AIL ADDRESS CITY ZIP PHONE <br />TENANT MAT. ADDRESS CITY ZIP PHONE <br />�' aPIrz;y _ 3y7-o 9Y� <br />ARCHITECTORDESIGNER MAIL ADDRESS COI ZIP PHONE <br />,��� t Bu�i/c .Po• Bo,raa�� �_ ve�e 7` 1r�ao3 3s y72--S <br />GENERALCONTRACTOR MAIL ADDRESS CITY ZIP PHONE uCENSE F <br />tic � ��,�Syj,�,Bi°//oGL <br />MECHANICAL CONTRACTOR MAIL ADDRESS C TY ZIP PHONE LICENSE F <br />PLUMGING CON TRAC TOR MAIL ADDRESS <br />Cl SS OfWORK <br />NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br />CONTRACT PRICE OF WORK <br />CONTACT PERSON AND PHONE NO <br />�'L�E BL%�yt/✓�"'%7G.J <br />DESCRIBE WONK AND BOYAR/OFOOTAGE <br />�oY CE���� <br />PROPOSED USE OF UILDING J <br />51A4/e E- <br />LEGAL DESCRIPTIO" OF PROPERTY SHOWN BELOW OR AT EACH FOUR COPIES) <br />LOT_ BLOCK �_ of <br />v <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 CONSTRUCTIC A OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 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 AND 296.200 WAC. <br />SIGNATURE OFCCONTR*A�CTTOR OR AUTHORIZED AGENT DATE p <br />-- <br />PP AN LS CIIV BUSINESS LICE ENO AND BUSINESS NAME <br />t�/�'C�� �. Sir. �L- <br />PR /OTECT ApORE55 / <br />pot -1 �t dF �,7b � � S% <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />TER CLOSET (TOILET) <br />A/C—AIHNDLG UNIT S—H.P. <br />BATHTUB <br />� <br />FORCED AIR SYSTEMS—B.T.U. M E.A.LAVATORY <br />(WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />PFEEWA <br />SIIOWER <br />CLOTHES DRYERSKITCHEN <br />SINK & DISP <br />VENTILATION FAN <br />UISHWASHER <br />RANGE HOOD _ <br />LAUNDRY TRAY <br />J <br />WATER HEATER _ <br />CLOTHES WASHER <br />—T <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOWPREVENTERS <br />; <br />GAS PIPING <br />_ <br />HOOF DRAINS—RAINLEADERS <br />I <br />_EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />--_— <br />_ <br />r <br />SUB TOTAL $ <br />�yZ�,T= <br />SUB TUTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE. $ <br />TOTAL FEE $ <br />FOR OFFICF URF ONLY- AAW I_IfY <br />FRONT SETBACK <br />7_47% <br />REAR SETBACK <br />SIDE BE Ac <br />/ <br />PLAN CHECK NUMRCjl <br />ELL 10 <br />/ <br />RE PT NO <br />1 i <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING z <br />PLUMBING <br />- 1 <br />i <br />IYM OF CONIS ALLOWABLL <br />�/✓ <br />TYPL DI CONS) ACTUAL <br />dCIIVAAO <br />MO d UWIwKc Uhl'S <br />MECHANICAL <br />LI ' <br />SIB OF <br />I <br />NO OF STORIES <br />BASEMENfT/ <br />ND <br />ADDITIONAL PLAN CHECK <br />i <br />CCUOAF FIRE SPRNKLERS REDO HEIGHT LIMITATION/ <br />REASONf RSPRINKLERS <br />n <br />.O.iHER— <br />KK,JJJ <br />_ <br />— <br />—T <br />STATE BUILDING SURCHARGE <br />/ Jr <br />INTAKE BY <br />PLANS APPROVED BV <br />1, <br />Tj n 3 q3 <br />CITY Of EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />40 , _ <br />TOTAL <br />�� <br />