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Q H <br />N <br />y H <br />T< ei <br />r'TI <br />y Oyu l:[IE-/511 <br />OH <br />H <br />gN H <br />o�Fn <br />Ea <br />1 <br />APPLICAl 114%N FOR CONSTRUI i ION PERMIT <br />TO BE COMPLETED IN INK —PLEASE PRINT <br />f'Ty <br />II <br />everett F <br />BUILDING DEPARTMENT <br />HEATING SYSTEM: J GAS J ELECTRIC 011 <br />everetl <br />e <br />2598810 <br />$e COMBINATION <br />BUILDING <br />MECHANICAL }PLUMBING SIGN <br />DEMOLITION <br />OWNER <br />MAIL ADDRESS <br />S� <br />CITY <br />�uFtF+4 <br />IIP PNOIIE <br />gBzoSc 3SSi�4a <br />I A�(ERAO%SPrizcc <br />Sp642A,zrr <br />TENANT <br />MAR ADDRESS <br />CITY <br />ARCHITECTORDESIGNER <br />MAIL ADDRESS <br />CRY <br />lIP PHONE <br />CITY 21P <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE/ <br />CLASS OF won" ,,.Al. InnM wnnnsTnVE/FRPL INSERT BUILDING RELOCATION <br />NEW y ADDITION ALI CMAI IVn <br />CONTACT PERSON AND PHONE NO <br />11 <br />— <br />I'D <br />__' <br />CONTRACT PRCE OF WORK I,jj�1 A/ b r <br />DEKAISE WORK AND BOUARE FOOTAGE INVOL�EO <br />1�v'''I � 1t=. Y T <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PPOPOSED USE Of BUILDING <br />Sp <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />IK,; AC <br />L 10 tC 1TJ <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LEGAL OEOF PROPERTY )SHOWN BELOW OR ATTACH FOUR CCWIE51 <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT BLOCK _ of <br />TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />n �D 7 <br />AUTHORITY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />THAT I AM AUTHORIZED BY THE <br />PERFORMANCE OF CONSTRUCTION. <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTO LAW 18.27 RCW AN 96.200 WAC. <br />S*NATURE OF IRA DR OR AUTHONIZ AOFNT DATE <br />2- <br />APPUCANTSCITV RUSINESSLICE AND INESSNAME <br />PE101ErCTADDPE88 I 1 _ <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM FE. <br />N0. TYPE OF EQUIPMENT FEE <br />AC—AHNDLG UNITS—H.P. ' <br />WATER CLOSET (TOILET) <br />FORCEDAIR SYSTEMS—B.TO. M E.R. <br />' <br />BATHTUB <br />UNIT HEATERS—B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK & DISP <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />' <br />CLOTHES WASHER <br />WOOD STOVE <br />' <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />—�— <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />�— <br />ROOF DRAINS—RAINLEADERS <br />EX AUST FAN <br />SINK(SERVICE—BAR, ETC.) <br />EL 2 6? <br />_ <br />I <br />SUBTOTAL f <br />_ SUBTOTAL $ <br />' <br />PERMIT i <br />-+� <br />PERMIT S <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE <br />FRONT SETBACK <br />USE <br />UNLT: <br />REAR BE TRACK <br />ul— <br />LOTAREA <br />/ ';«i <br />SIDE SETBACK <br />VACANTSITE <br />A <br />PLANCHE ANLIMBFR FEE <br />ol <br />FEES <br />RECEIPT NO <br />FEE _ <br />BUILDING <br />- <br />PLUMBING <br />xVALUATION <br />Y�(�j '� <br />--� <br />' — <br />' <br />TYPE DICOILTSN.LVWABII <br />TYPT JIC ST ACTUAJL <br />_ <br />ALLWELr <br />aaIAHI,R6 PIiR <br />MECHANICAL <br />- <br />F <br />SIZE OF BLDD NO OF STORIES <br />5� 4f41 1 <br />OCCUPANCY LOAD FINE BPRNIfLERB RELIC <br />NI <br />REA FORSPAWKLERS <br />BASEMENT <br />u° <br />MITT LIMITATION <br />PP <br />CITY OF EVERETT <br />TAX CODE SLES 3105 <br />ADDITIONALPLANCHECK <br />OTHER <br />T_ <br />STATE BUILDIt.3 SURCHARGE <br />PUBLIC WORKSLOCAL <br />INTAKE BY <br />-------------- <br />PLANS APPROVED BY <br />TOTAL <br />` UrJ <br />