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APPLICATIOO FOR CONSTRUCT+N <br />PERMIT <br />KSEFREE, ADM AND SDDARF POOIAGE INVOYED <br />TO BE COMPLETED IN BLACK INK --PLEASE PRINT <br />I <br />\ 1St,TAL-L_ )I-tc T1.L C-. �Flk0. u e <br />_ <br />HEATING SYSTEM: O GAS ❑ ELECTRIC J <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 />B <br />BUILDING DEPARTMENT <br />LEGAL DEBCRIPIKYI UK PPDPERry lswrm BELOW OR ATWH TM WRILSI <br />LOT PLCCN Of <br />--'-_-- <br />VALUi1i ION <br />2598810 <br />CONSTRUCTONLWNIENOER. ADDRESS 1ELEPHONENUMBER <br />PROJECT ADDRESS) -(±- <br />Jri�)� ��(% �. <br />'.J DEMOLITION <br />I COMBINATION LI BUILDING U MECHANICAL <br />_: PLUMBING D SIGN <br />� <br />�n�T <br />M.��3BL �,2r <� lchZIP <br />cL1y I� °qa�o� <br />1ENANT <br />WKAOdiEES C. 21P PANE <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />ARCMRECT 011 DE$IONEP <br />WA ADDRESS CRY ZIP PRONE <br />KITCHEN SINK $ DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />GENERAL CONTRACTOR <br />WILADDRESS CITY ZIP PRCNE <br />SIRE LICENSE <br />l Pti.lr <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />MECHANCAL COITPACTON <br />MAIL ADOUSS CRY ZIP PRONE <br />SIATE MENSEA <br />es c <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />PLNIERIGCWTRACTOR <br />_ <br />MAAADDRESS CITY ZIP PHONE <br />STATELKDN * <br />CWiflACi PPIC OYIUNF_ <br />` / _. I�EZ. SCO mac_ <br />KSEFREE, ADM AND SDDARF POOIAGE INVOYED <br />CCN I PERSON AND PRONE NO <br />I <br />\ 1St,TAL-L_ )I-tc T1.L C-. �Flk0. u e <br />_ <br />USE ZONE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <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 />B <br />PROOSEDUSE DF BNADING <br />LEGAL DEBCRIPIKYI UK PPDPERry lswrm BELOW OR ATWH TM WRILSI <br />LOT PLCCN Of <br />--'-_-- <br />VALUi1i ION <br />PARCEL TAN I o. NUMBER <br />CONSTRUCTONLWNIENOER. ADDRESS 1ELEPHONENUMBER <br />PROJECT ADDRESS) -(±- <br />Jri�)� ��(% �. <br />-tMFLNvy. wRt <br />ue. ALLSAdASI4ER6l RN) <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. I TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />AC-AIHNDLG UNITS-H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK $ DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHESWASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAINHEAT <br />PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAIN-RAINLEADERS <br />EXHAUSTFAN <br />SINK (SERVICE -BAR. ETC.) <br />SUBTOTAL $ <br />(� ' <br />SUBTAFEES <br />PERMIT E <br />PERMI <br />TOTAL FEE S <br />TOTAL <br />FOR OFFICE I ICF Ettll V• m <br />FRONT dETBACK <br />RCARSfTEMC1! <br />SIDE SETBACK <br />PV.N CNE NNULRBEn <br />all <br />I!f <br />7c'EIPTI:: <br />USE ZONE <br />LOTARFA <br />VApAMSITE <br />Ll YES ❑ NO <br />FEES <br />VALUi1i ION <br />FEET <br />BUILDING <br />.—. <br />_ <br />TSR O1 COWV <br />W.OF bTp11NEs <br />omwcr AO OFM".IAIs <br />LAfl'" <br />PLUMBING <br />"':I aF BLDG <br />FOB: SPPNKLFRS PEOD <br />fMSFMExT <br />❑ YES n NO <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />nCCUPMGYLOAD <br />FIREALARMREOD <br />RESORT LAIITATON <br />OTHER <br />-- <br />Gi nsoN <br />.I n. J., PUN%APPnrnEo er CITY OF EVER ETT <br />'OCAL SALES <br />BATE TAX CODE IS 3105 <br />STATE BUILDWD SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />