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TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />HEATING SYSTEM: U GAS <br />U ELECTRIC <br />J ._ <br />BUILDING DEPARTMENT <br />259-P310 <br />��v(./(jAlr i7o. <br />I 1 DEMOLITION <br />Li COMBINATION <br />11-BUMI IG <br />D MECHANICAL <br />OWNER <br />MAIL ADDRESS <br />CITY 1 1 <br />R_, <br />ZIP <br />R8611 <br />PHONE <br />2ml - <br />c•, L ro, v+Tnn <br />14519 RIOc3U �flfffr I� <br />�T21ti onan Mkt <br />TENANT <br />MAR. ADDRESS <br />CITY <br />�? �fC <br />21P <br />PHONE <br />nle I act+ucy�r^o <br />hS`t <br />YN <br />«I515 <br />CITY <br />ZIP <br />PHONE <br />i I PLUMBING l_l SIGN <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZLP '. `N PHONE <br />9j052 61�' <br />STATE LICENSE <br />\� �,�L �LZ{7�. <br />�.0 <br />dJ�iPIN �AIr N(. <br />DI�K <br />LIAI <br />I:JJO�( <br />V V 1 L <br />t.�JA.{�l�nlAl„AT- <br />CITY <br />21P PHONE <br />STATE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />STATE LILENSE I <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CONTRACT PRIDE OF K <br />E51 ZooO <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO { <br />c <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />raoPOseD usE GF BUIIDIND <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />L <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />TWO COPIESI <br />LEGAL OESCRIPTM]N OF PROPERTY ISNOWN BELOW OR ATTACH <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />OF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />LOT BLOCK <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAI I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />r� \ <br />{ 7 <br />_ y hhhJJJ <br />APPLICATIO MADE AND I COMPLY WITH THE STATE <br />CON. AND 296.200 WAC. <br />PARCEL TAXI D. NUMBER <br />CONSTRUCTION LOAN IENDER. TELEPHONE NUMBER <br />}1�E55. <br />y0 5 <br />PROJECT ADDRESS <br />btY BI15Mf 55 UCFHSf NO <br />MECHANICAL <br />FEE <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO' <br />TYPE OF ES—H.P ENT <br />NO. <br />NC—A/HNOLG <br />' <br />WATER CLOSET (TOILET) <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />, <br />BATHTUB <br />UNIT HEATERS—B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />'• <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK & DISP <br />RANGEHOOD <br />' <br />) <br />DISHWASHER <br />' <br />WATER HEATER <br />LAUNDRY TRAY <br />L <br />WOOD STOVE <br />, <br />' <br />1 <br />CLOTHES WASHER <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />URINAL <br />FIREPLACE INSERT <br />' <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GAS PIPING <br />�- <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE —BAR, ETC.) <br />I <br />I <br />EXHAUSTFAN <br />, <br />' <br />' 1 <br />I <br />I <br />I <br />SUBTOTAL $ <br />' <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT $ <br />I <br />TOTAL FEE $ <br />_ <br />' <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONTSEIBACK <br />REAR SETBACK <br />LOTAREA <br />USE ZONE <br />TYPE DT CONST <br />NO OF STORIES <br />.m AJ <br />l <br />SIZE OF BLDG. <br />FIRE SPRINYLERS RED <br />No e w--f <br />4"5 <br />OCCUPANCY LOAD <br />FIRE ALARM REED <br />dx� otwn�� <br />4� s <br />rX� 977W IWIIPM <br />INTAK BY PLANS APPROVED BV <br />DATE 11/ 9,0A4 <br />SIDE SETBACK <br />'•�"�'.... <br />VACANT SITE <br />FEES <br />❑ YES ❑ NO <br />BUILDING <br />dxw.RCY <br />RR ORAtIIRG IXRI6 <br />132 <br />PLUMBING <br />BASEMENT <br />MECHANICAL <br />❑ YES ❑ NO <br />PLAN CHECK <br />HEIGHT LIMITATIONADDITIONAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />FEE <br />