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APPLICATIO.J FOR CONSTRUCT. l.� <br />TO BE COM�LETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �— <br />259-8810 <br />O DEMOLITION CI CUMBINATION <br />OWN MRIL ADORESS <br />��� �Z����`�� � <br />TENANT�\�Q MAILAODRESS <br />1 ` <br />RRCMITECT Olj DES� R MAIL pDDNE55 <br />� 1 <br />GENERpLCONTFjRC� IAAILADORESS <br />r � � <br />MECMFNICALCONTR�C MAILRDDRE55 <br />��� • � <br />PLUMBINGCONTR�CTOR MAILp�ORESS <br />CO[�(iACT PI�CF, QF WOaN f� '^T <br />4;rn � � �_��� � r� <br />\yD Ol,\lJ�J l `��J <br />DESCRIBE WORK AND SOW RE PWTAGE INVOlVEO <br />HEATING SYSTEM:�] GAS ❑ ELECTRIC Cl <br />Cl BUILDING �Q <br />CIiY 21P <br />��e,v e � �y (��\ � <br />CITY ZIP <br />CITY ZIP <br />LITY ZIV <br />LEGRL DESCflIPTION OF PPOPERTY (SHOYM BEIOW OR ATTRCN TWO LOPIES� <br />LO� BIOGK OF � <br />PARCELTA%I.p.NUMBER <br />CON5IHUCTION LOAN LENOER, ADORESS, TELEPHONE NUMBER <br />OF FIIfTURE OR ITEM <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOIi DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DHAINS—RAINLEAC <br />SINK (SEHVICE—BAR, ETC <br />FOR OFFICE USE ONLY: <br />FRONTSETBALK RE�HSETBRCK <br />tISEIONE LOTAflEA <br />IYFE OF CONST <br />SIZE OF BLD[3. <br />OCCUPANCYLOAD <br />REASON <br />INTAKE BY <br />SUO TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FIRE SPRINNLERS HEO'D <br />FIRE AURM NEOD <br />PIANSAPPROVEDBV <br />DAiE <br />CITY IIP <br />dTY ZIP <br />GONi�CT PERSON AND PMONE NO. <br />PMONE <br />PMONE <br />PNONE <br />PHONE <br />� <br />�cE�u� n <br />!:!!.' <br />`�ii <br />❑ PLUMBING ❑ SIGN <br />�a.�� a9o-�3q <br />STATF lI1;EN5E � <br />STRTE <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 PERM�T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHEfl STATE OR LOCAL LAW REGULATING CUNSTRUCTION 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 1827 RCW ANU 296200 WAC. <br />x�r�iUlc) ��a.u:�e1✓.J.�l.cr..� 71�3/93 <br />5�G .1tU-Z1 �- TD�iE <br />FEE N0. TYPE OF EOUIPMENT <br />� A/C—A/HNDLG UNITS—H.P. <br />' FORCED AIR SYSTEM.S—B.T.U. M E.A. <br />� UNIT HEATERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE I <br />FIREPLACEINSERT <br />HEAT PUMP <br />PUN <br />Vr1CANT5ITE rees � <br />❑ YES ❑ NU BUILDING <br />occuv.�vcr xoawrtuwcuxrts <br />GRWP PLUMBING <br />BASEMEN7 MECHANICAL <br />❑ YES ❑ NO <br />HEIGHT IIMITRTION A�DITIONAL PLAN CHECK <br />OTHER <br />STATE Bl11LDIN3 SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS �10F TOTAL <br />PECEIPT NO. <br />FEE <br />� <br />i <br />i <br />I <br />�� <br />1 <br />� <br />i <br />� <br />--i <br />i <br />i <br />� <br />� <br />—� <br />� <br />