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APPLICATIQ''1 FOR CONSTRUCT'�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT �— <br />259-8810 <br />DEMOLITION COMBINATION <br />ow� n ,• rrm�nooness <br />i <br />J�'�+ ��,�p .L�l��' � Y't�,�! <br />i�Nnr+r �,�nanooaess <br />HEATING SYST[M: �J GAS J GLECTRIC J <br />ARCHIiECTOR�E5IGNER MAILADDRESS <br />GENER�LCONTRACtOR MAILAOOIIE55 <br />Li.'/� ,�, i f �' �l <br />�b- � . ,�, ,,; i�/: - �5� f <br />IA[CHANICALCOMfiAGTOR MNLpU�RE55 — <br />PLUTABINGCONiPPCTOR M41LA[]OflE55 <br />f.ONTR4LTPRICF.OFY/OAK � / <br />�/1� r l'. <br />DESCRIBE WOIiN AhD SOUABE FOOTAGE INVOLVED <br />;l BUILDING <br />citv <br />a. <br />CIiY <br />;� <br />CIiY <br />C�T� <br />MECHANICAL <br />zir w�or�o <br />il ; �.�/ ��'' ��" <br />zm aHONe <br />21V PNONG <br />PLUMBING SIGN <br />ZIP PMONE Sir1TELICENSE♦ <br />/� �6.•d5� ?3Y-/,i: s � � � , �' ; �� <br />ZIP PNONE 5:4TELICENSEs <br />ZIP PIIONE $TAi�LICENSE• <br />�E N ANO PI �E NO � <br />/in/ ,�i��/��/ � i �—.r�/� 5 <br />'' � '' � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PROPOSEouLseoFAiA piNc � qPpLIJATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />�IJL�lM�(,./Is PROVISIONS OF LAWS AND QRGINANCES GOVGRNING THIS TYPE OF <br />�tun�-0ESCRIPTIONOFPROPERiY�SNOYlNOELOW09ATTACNTWOLOP�ES� WORK VJILL OE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�_ V� G�/,� i NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />�oT- �tocK � oF AUTHORITY TO VIOLATE OR CANCEL THE ?ROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW RFGULATING CONSTRUCTION OR THE <br />— PERFORAIANCE OF CONSTRUCiION. THAT I AM AUTHOFI2ED BV THE <br />OWNER OF THIS PROPEFTY TU PERFORM THE WORK FOR WHICH <br />— APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />PAFCELTA%I� NIIA�BER <br />3 i s7_ �� �,C ,� �� y CONTFACTORS LAW 10.27 RCW A D�J6.200 WAC. <br />CO":STRUCiIONLGANIENDER.�D�RE55.7�.EPMONENU1d�ER I/ ��/ <br />�� � / � '/� � � � //..y / �� � ( � <br />PR�JECT AD-D7RESS�7 sia c � � ��ic <br />� 75 S /� /<fl/f1L�i/ �%✓�� unmisviEssu;nai �� — <br />PLUMBING / <br />NO. TYPE OF FI%TURE OR ITEM <br />LAVATORY ( WASH BA: <br />SHOLNER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIh <br />��ACKFLOW PREVENTERS <br />ROOF D�;AINS—RAINLEAL <br />FOR OFFICE USE ONLY: <br />FRONiS@1�ALK R[�RSETPACN <br />UiF.20NE IOTAREA <br />rm[ ar mr�sr <br />517F. OF pLDG <br />OCCUPANCYIOAD <br />REnSON <br />iNrnn[ uv <br />9 <br />PERMIT $ <br />TOTALFFE 3 <br />FiRE SPRINKL[RS REOD <br />FlRE Al RR1.1 REO D <br />PLnNS nrPnW Eo ov <br />onr[ <br />51�[ SElbn.:l' <br />A�'C—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGFHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPIACE (WOOD Bl1RNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />V�CnNT SITE eFFJ <br />� YES � �- NO pWLDING� <br />urru,-a•,cr r�on�owtu�xc��na — <br />,v,, n <br />� PLUM6ING _ <br />oASE1dEN7 MECHANICAL <br />YES NO <br />HEiGirt LnaiTniioN AODIiIONAL PLAN CHECK <br />OTHER <br />STATE OUILDING SURCHARGE <br />CITY Df EVERETT PUOLIC N'ORNS <br />LOCAL SALES <br />TAX CODEIS 3105 TOTAL <br />FCE <br />— - � - <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE 5 <br />FEE <br />0 <br />A <br />� <br />. <br />