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APPLICATION FOR CONSTRUCTIAN P'ERMIT �� <br /> TO BE CCn.iPLETED IN BLACK!NK—PLEASE PRIN i � �T� <br /> BUILD�NG DEPARTMENT HEATiNG SYS7E1d: �GAS J ELECTRiC J __ __ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> OWNEF • ui �nrep *y 2iP / oNpNE <br /> TENR��� � l/Il ADDFESS ���TY ZIP �� FM1NE <br /> . / <br /> ARCHITEGT )RDES�GNEA MAILN�DAE55 OtV ji� P�qYE <br /> �GE ERAIICrONTRq�TOR M�IiADDRE55 I 1I GnITv ZIP >HONE STRTELiCE!15E• / <br /> (7Y't-V1�lG_. li1 rhec��v/ ��l�l y�lll ��—IUa aaY � r��l /—,,J J�_.���l�131.t:V1�J�3 �� <br /> MEGMANIC0.CONTRACTOR MqILADDRE55 CITY ZIP PMONE STATEUGENSE• <br /> PIUMBING CONTRRLTOP MAIL�DDRE55 qiV 2iP VHONE STATE ll[ENSE• <br /> � <br /> ✓ <br /> GONTRaCT VFICE OF WOaN <br /> �� �� `� <br /> OESCAIBE WORN ANO SOUAHt�tx��GE INVOWED CONiPCT PERSON RND VHONE NO <br /> �s �rY� �., � � ��.�.�,� <br /> � �,� _ - <br /> �� . I HEREBY CERTIFV THAT I HAVE READ AND EXAMIIJFD THIS <br /> PROPOSED US[OF BUILDiNG � APPLICATION AND KtJOW THE SAME TO BE TRUE AND CGRFECT ALL <br /> PROVISIONS OF LHWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCFIPTIONOFPROPEFTY�SNOWNBEIOWONATTACMiWOCAPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT-- BLOCK oc qUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV ' <br /> � OTHER STATE Ofl LOCAL LAW REGULA7ING CONSTRUCT�ON OR THE <br /> � T— PERFORM17ANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BV THE <br /> � OWNEfl OF THIS PROPERTY TO PERFO�M THE N'ORK �OR VJHICH <br /> - .- _ - APPLICATION IS �dADE AND I COMPLV WITH THE STATE <br /> ana.ce�rn, �,o NUMecn CONTRACTORS LAW t8.27 RCW AND 2962G0 WAC. <br /> CONSTRUCTIONLO�NLENDER.ADDiiE55,TELEPHONE NUMBER �� <br /> PROJ CT ADDR " ' 'E o"rf��� � � <br /> LiT�fl�SwF 55 i iC[:P_S^ <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOiLET) A'G—A+iIJDLG UNITS—H.R _ <br /> BATHTUB FORCED AIR SYSTEMS—B.T,U. M E.A. _ <br /> LAVATORY�WASHBASIN) � UNITHEATERS—B.T.U. M � <br /> ---r <br /> SHOWER CLOTHES DFVEFS <br /> KITCHEN SINK 8 DISP VENTILATION FAN ' <br /> -'---� <br /> DISHWASHER � RANGE HOOD <br /> LAUIvDRVTqAV ' WATEF HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNINGI <br /> DRINKING FOUNTAIN FIREPLAGE INSERT <br /> I"LOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVEIJTERS ' GAS PIPING .____ <br /> I��OF DRAINS—RAINLEADERS —T � EXHAUST FAN _ _ <br /> :INK(SERVICE—BAR.ETC.1 ' � <br /> � <br /> SUBTOTAL $ SUBTOTAL 5 l ; <br /> PERMIT 5 PERNIT g _�jT__ <br /> - --- -- --�— - �--� --- �------- — <br /> TOTAL FEE S ' � TOTAL�EE 5 �h�'�' ' <br /> FOR OFFICE USE ONLY: <br /> FFONTSETBACN FEARSETBACK SIDESETBAGN PLANCMELNNUMBER FEE RECEIPTNO <br /> � I I <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> ��. YES . NO BUiLOiNG <br /> 7YPE Oi WNc- NO OF STORIES xu=44n ��c o�Jnf�..��,o.v's —" -- ------ ' -�-- <br /> i <br /> °P0`i° PWMBIIJG <br /> —T— <br /> SIZEOFBLD6. FIRESPRINNIERSREO'� 3ASEMENT MECHANICAL � I <br /> C YES = NO <br /> OCCUPANC°LOAD FIR[ALANM REOD HEIGHT LIMITRTION ADDITIONAL PLAN GHECK <br /> OTHER <br /> REASON ---�T <br /> StAiE OUIL�ING SUHCHnRGE � <br /> INTANE BY PLANSAPPROVEDBV CITY OF EVERETT PUBLIC'NOFKS I <br /> LOCAL SALES <br /> oqTE TAX CODE IS 3105 rorn� <br />