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APPLICATION FOR <br />YYlF!„ <br />ths <br />leml <br />CITY OF <br />OTT <br />CONSTRUCTION <br />everett <br />PERMIT <br />BUILDING DEPARTMENT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />259•8745 <br />❑ DEMOLITION ❑ COMBINATION pQ BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />OWNER <br />MAIL ADDRESS CITY TIP <br />po Sox R841 SeasFN+� 98109 <br />PHONE <br />'Lef 8700 <br />olat r orwf:__ <br />ARCIIIT[C ROESIO ER <br />Art h,t45 <br />MAIL ADDRESS CITY ZIP <br />Sol EIIIe+Y Ave, W. a505 Staitlt 98119 <br />PHONE <br />983.4 A <br />LPG <br />GENERAL CONTRACTOR <br />I <br />MAIL ADDRESS CITY ZIP <br />P.o•'Box 9047 Sto-ttit 98100 <br />PHONE <br />281-8252- <br />LICENSE <br />SE9CLS*sG7L,P <br />QArkl 5}FE�-Araf Vic, • <br />MECHAN'CA CONTRACTOR <br />MAIL ADUBE99 CITY TIP <br />PHONE <br />LICENSE A <br />PHONE <br />LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />COClA59 OF WORK <br />SS❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSERT ❑ BUILDING RELOCATION <br />VALUATION OF WORKI009T OF MATERIALS PLUS LABOR' <br />11 1750 000 W <br />_. <br />J . .11_ <br />Tb QQD .SF -I III -4 ulv w.. r. _ <br />- - - _ _ - <br />us OFBUILDINO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />/� <br />�CIEc Yl1gVYlAtM LL <br />PLICATION AND KNOW THE SAME TO BE TR' EANDCORRECT.ALL <br />LEGAL DE9CNPHONOF PROAE.IMNOWNBELOWORAITAC FOURCOPIESI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />LOT- BLOCK -OF <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br />ANY OTHER STATE OR I OCAL LAW REGULATING CONSTRUCTION <br />0.44-,L <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Or CONTRACTOR OR AUTHORIZED AGENT DATE <br />X U�. 9 3 �86 <br />p <br />II 15 75 j4 Ci Su) @lY�al <br />PROJECT ADDRESS <br />APPLICANTS CITY BUSIN LICENSE NO <br />.may ct c_�A/ <br />18390 <br />PLUM NO <br />MECHANICAL <br />NO. TYPE OF FIXTURE FEE <br />NO. <br />TYPE OF EQUIPMENT FEE <br />WATER CLOSET TOILE <br />AIR COND. UNITS—H P. EA. <br />BATHTUB <br />REFRIGERATION UNITS—H. P. EA. <br />LAVATORY JVVASH BASIN) <br />BOILERS—H.P. EA. <br />SHOWER <br />OAS FIRED AC UNITS —TONNAGE EA <br />_ <br />KITCHEN SINK f DISP. <br />FORCED AIR SYSTEMS—B_T UU M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNORYTRAY <br />UNIT HEATERS—B T. U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE 9 _CHIMNEY <br />_ <br />_ <br />SINK SERVICE —BAP, ETC.' <br />WOODSTOVE/FIREPLACE INSERT <br />8U0 TOTAL <br />SUB TOTAL f <br />PERMIT 3 <br />PERMIT f <br />TOTALFEE { <br />TOTALFEE ! <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />FRONT SETBACK <br />O <br />NEAR SCIpACK <br />O <br />SIDE SETBACK <br />1 <br />PLAN CHICK NUMBER <br />�% <br />^� I / / <br />PLAN <br />CHECK FEE <br />RECEIrT N0 �DJ(` /`USE <br />ZONE <br />LOT AREA <br />VACANT SITE <br />ONO <br />FEEB <br />FEEo�OY•83MftE4 <br />L22��Z <br />'S 03 <br />.As <br />TYPE OE COAST <br />OCCUPANCYGnOuP <br />NO OF DWELLING UNITS0BUILDING <br />91TC O1„fllOO <br />11^� SF <br />NO Of 510KILS <br />AT OC/Cf <br />LOAD <br />1 ZE- <br />'T <br />PLUMBING <br />FIRE SPRINKLERS REQUIRED XYES ONO <br />MECHANICAL <br />OTHER <br />PENALTY <br />APPLICATIONACC pY <br />1'LANSCHEOKED BY <br />J <br />APPIl FOR199UANCE BY <br />TOTAL <br />