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APPLICATIC V FOR CONSTRUCT" 7 RMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT 7 �71`' . 0 K <br />HEATING SYSTEM: 1W GAS U ELECTRIC I,J <br />BUILDING DEPARTMENT <br />269-8810 CII-Y OF EV[RL'TT..... <br />CI DEMOLITION I I COMBINATION i I BUILDING 154AECHANICAL PDplipw"l1� t ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />LClyk Fos ,iii")fk Si SE folIs -H 1)1 -C•Y _31/7-clSR <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CRY ZIP PHONE <br />GENERAL CONTRACTOR MAR ADDRESS CITY ZIP PHONE STATE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CRY ZK' PHONE STATE LICENSE 1 <br />�Sv)nIC•k_ 111C 11h3o SIq.1pr J1v, — ll._lyIQNc( `1S03y $a3.44Sy SvnILt 7'Y NU 7J(.0 <br />CONTRACTOR MAIL <br />Cm <br />PHONE <br />F <br />CONTRACT PRICE OF WORK <br />53a� — <br />' <br />DESCRIBE WORK AND SQUARE F•)OTAGE INVOLVED <br />CONTACT P RSONA ;P/ION� <br />'] <br />LOYYUBv* ji-ta A'VLQT-s /1CT A4L14 }Q �V1 <br />I HEREBY CERTIFY THAT I HAVE HEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING ` <br />``' <br />--A ) I `� )' \' <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 ISHOWN BELOW OR ATTACH TWO COPIESI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK OF <br />— <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 />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />CONTRACTORS <br />PARCEL TAXI D. NUMBER <br />C.t <br />3 y C O� <br />c� <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />PROJECT ADDRESS <br />"(�„ S��f \i�f) <br />FKPIAIwP R"tc <br />�>1 <br />i j.1 A <br />city nusnrtns a-rrrc in <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AtC—AiHNDLG UNITS—H.P. <br />_ <br />BATHTUB <br />' <br />I <br />—L <br />FORCED AIR SYSTEMS—B.T.U. !A E.A. <br />; <br />LAVATORY (WASH BASIN) <br />— <br />UNIT HEATERS—B.T.U. M <br />—'— <br />SHOWER <br />;— <br />_CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />; <br />VENTILATION FAN <br />DISHWASHER <br />' <br />_RANGE HOOD <br />' <br />LAUNDRY TRAY <br />I <br />_ <br />_L <br />WATER HEATER <br />I <br />CLOTHES WASHER <br />1 <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />.' <br />_ <br />BACKFLOW PREVENTERS <br />i <br />( <br />GAS PIPING <br />' <br />_ <br />ROOF DHAINS—RAINLEADERS <br />1 <br />EXHAUST FAN <br />' <br />SINK (SERVICE —BAR, ETC.) <br />' <br />t <br />I <br />I <br />SUB TOTAL $ <br />1 <br />SUB TOTAL $ <br />' <br />'(W <br />PERMIT $ <br />PERMIT $ <br />100 <br />TOTAL FEE $ <br />' <br />TOTAL FEE $ <br />S' <br />rum VrrIA"C Mom <br />VIYLT• <br />PLAN CHEC UMBER <br />FEE <br />RECEIPT NO <br />FRONTSETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />vs Z-5v <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />' <br />10 YES ❑ NO <br />TYPE OF CONST. <br />NO, OF STORIES <br />/CpAVMty <br />MD gIM1HMGINi16 <br />--- <br />' <br />PLUMBING <br />MECHANICAL <br />('') <br />SIZE OF BLDG <br />FIRE SPRINKLERS REOD <br />BASEMENT <br />13 YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />t <br />OCCUPANCY LOAD <br />FIRE AIARAI REDD <br />HEIGHT LIMITATION <br />t <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />I <br />PUBLIC WORKS <br />INTAKE BY <br />PLANSAPPROVEDBY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TataL <br />9 c, �� <br />DATE <br />