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APPLICATIC <br />. FOR CONSTRUCT <br />)N PERMIT <br />TO BE COMPLETED <br />IN BLACK INK —PLEASE <br />PRINT <br />BUILDING DEPARTMENT <br />❑ __ <br />HEATING SYSTEM: U GAS <br />L_ ELECTRIC <br />259.8810 <br />❑ DEMOLITION C I COMBINATION <br />❑ BUILDING <br />14MECHANICAL [4fLUMBING [I SIGN <br />O(nWj NEnR MAIL ADDRESS <br />1"I';U- G=L? f%A n t-to:Ja � 3a <br />CITY moo^ <br />AVt Sg EA tom- <br />p <br />C{sot7- <br />PHONE <br />_74a-ITI$ <br />TENANT MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />�^' <br />ZIP <br />PHONE <br />Ii< In' �w.f��.l�oA�id <br />9505'A <br />ItA+e G Q9_L_k � <br />CNZ6l <br />'Na <br />GENERAL CONTRACT011 <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />'143-1118 <br />STATE LICENSE A <br />L �yeJ L-p l <br />nb3�- <br />3st'tAucsa tRLt4w_a <br />wBol} <br />AderReaEo <br />ECHA K:AL CONTRACTOR <br />AA. ADDRESS .. IL I fj <br />4�4L <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE I <br />NaQ�Z i�l <br />�oRLaerr t <br />w 3b0' <br />o TEA <br />�+1 <br />9b0�7 <br />131Dv- <br />PLUMBING ONTRACTOR <br />l <br />MAIL ADDRESS <br />hA' l <br />CITY ZIP PHONE STATE LICENSE F <br />5',aNE MaR odd g i' RQ DZ I«5E <br />�AY� <br />LONTIT PRICE OF WORN <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPOSED USE OF BUILDING <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 (SHOWN BELOW OR ATTACH TWO COPIES) <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOT— BLOCK OF — <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />- <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 />c` <br />PARCEL TAXI D NUMBER <br />CONSTRUCTION LOAN LENDER, ADDRLSS. TELEPHONENUMBEP <br />�_ /C I I— <br />PROJECT ADDRESS L/�s <br />(Q <br />Sn AIUAF 9 _ nMI <br />CiTYRU9NF�'F ASFNSF1.� <br />PLUMBING 1 <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />? <br />AC-AIHNDLG UNITS-H.P. <br />BATHTUB <br />-2 f <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />'y _ <br />LAVATORY (WASH BASIN) <br />I <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRY TRAY <br />IWATER <br />HEATER <br />' <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />' <br />DRINKING FOUNTAIN <br />r <br />FIREPLACE INSERT <br />i <br />FLOOR DRAIN <br />HEAT PUMP <br />' <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />I <br />EXHAUST FAN <br />' <br />SINK (SERVICE -BAR, ETC.) <br />I <br />' <br />, <br />I <br />' <br />I <br />SUBTOTAL E <br />SUBTOTAL 6 <br />' <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE S <br />' <br />TOTAL FEE 5 <br />' <br />run vrmoc Han <br />FRONT SETBACK <br />USEZONE <br />vn.n. <br />REAR SETBACK <br />LOTARZA <br />SIDE SETBACK <br />VACANT SITE <br />fl YES ❑ NO <br />PLAN CHECK NUMBW FEf <br />FEES <br />VALUATION <br />RECEIPT NO <br />FEE <br />BUILDING <br />PLUMBING <br />-- <br />TYPE OF CONST <br />NO OF STORIES <br />mlm l <br />A"aP <br />AOIXPWDIARAIR <br />MECHANICAL <br />r <br />' <br />SIZE OF BLDG <br />FIRE SPRINKLERS REGO <br />BASEMENT <br />F1 YES ❑ NO <br />ADDITIONAL PLAN CHECK <br />1 <br />OCCUPANCY LOAD <br />FlRE ALARM RED <br />HEIGHT LIMITATION <br />OTHER <br />REASON <br />STATE BUILDING SURCHARGE <br />� <br />PUBLIC WORKS <br />I <br />INTAKE BY <br />PLANS APPROVED BY <br />DATE <br />CITY DF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />I, <br />