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APPLICATION FOR CONSTRUCTInN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—pLEASE PRINT ��� <br /> BUILDING DEPAATMENT HEATING SYSTEM: GAS ❑E�ECTRIC :J <br /> 259-8810 ' l� <br /> -' DEMOLITION ' COMBINATION BUILDING ECHANICAL : PLUMBING <br /> /-("'ER MAi{,qDORESS — SIGN <br /> CITv JE '7 <br /> TENANT � �I�` � �� C.O1� �� J i C� �V� j�f 'LJJ� <br /> \ MAI�ADDRES$ pTY jiP PMpNE <br /> ��� <br /> ARCNf�EC7�S�GNER MAIL�ODRE55 CiTY <br /> `I I I Z�P PMONE <br /> GENERFLCONTq��TOR M4I�ADDRE55 CITv <br /> � I� Z�P P'roNE ST�TE LK:ENSE• <br /> MECX�NICALCONT CTOR MqILADORESS C�TY <br /> `(�,l�. � Z�P PMONE STnTE LiCENSE• <br /> c�t <br /> PIUMBINGCONTR�CTOR MAIIADDRES$ CITV 2iP <br /> ;i FNONE STRiE LICENSE Y <br /> CONTg�T PR�LE OF WpqN <br /> ww a-��5.D0 <br /> DERCRIBE WOHN ANO SOUARE FOOiAGE INVOIVED <br /> � COHTA�T PERSON Ar1D�MUNE NO <br /> � 11\`��t, �\��nc� Cc� � �,.cv �� <br /> �_� ��, <br /> PROPOSEDUSEOFBUILDIN � HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> �� APPUCATION AND KNOW THE SAME TO BE TFUE hND CORRECL ALL <br /> PROVi510NS OF LAWS AND ORDINANCES GOVERNING 7HI5 TYPE OF <br /> LEG�LDESCNIPTIONOFPROPBRTv�SNOWNBELOWORATT��MTyOCOPIE51 WORK WILI BE CO�dPLETED WIThI WHETHER SPECIFIED HEREIN GR <br /> r.oi. etoCK Op _ NOT. THE GRANTING OF A PERNIIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY 70 VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER S7A1'e OR LOCAL LAW qEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUC710N.THAT 1 AM AUTHORRED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> PARCEITP%ID.NUM6EF APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1927 RCW AND 296200 WAC. <br /> CONSiRUCTIONIOANLENDEP,ApORE55.TElEVHONENUMBER <br /> PROJECTA DRESS � X �����K�� 1 ���'i�G-q� �-�� ��'� <br /> \� � .roM�ru [ o�r[ <br /> PIUMBING �"�����-^+rss uce�.se.io - <br /> NO. TYPE OF FI%TURE OR ITEM MECMANICAL <br /> FEE N0. TVPE OF EDUIPMENT FEE <br /> WATER CLOSET�TOILET� � A C—A�HNDLG UMTS—H.P. <br /> BATHTUB ' FORGED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASN BASIN) UNIT HEATERS—BS.U. M � <br /> SHOWER CLOTHES DRYERS --'-'— <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RAIJGE HOOD <br /> LAUNDRVTRAY WATER HEATLR <br /> CLOTHES WASHER <br /> WOOD STOVE <br /> URINAL METAL FiREPLACE�WOOD BUFNING) �— <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR JRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPWG <br /> ROOF DRAINS—FAINLEADERS � EXNAUST FAfJ <br /> SINK(SERVICE—BAR,ETC.1 � _ <br /> � <br /> SUB TOTAL S ' <br /> SUBTO7AL g �p � <br /> ___ PERMIT $ PERMIT $ � � <br /> TOTAL FEE $ ' TOTAL FEE S .•�—', .I <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK RLARSETBACK SI�ESETB4CK <br /> VI�YGHFGN NUMBER FEE NECEIPiNO <br /> r �—/. <br /> USE ZONE LOT ARE� Vr1C�NT SI7E <br /> FEES VALUATION FEE <br /> r' YES �-; NO <br /> ivrto�COusi ND.oFSTORiES BWLDING <br /> �cc„vwn ��onrmvq��•.c.v..s � <br /> ccauo <br /> PWh^BING ' <br /> SIZEOFBLDG FiqESPRINKLER5pE00 BASEMENT <br /> .J YES � NQ MECHANICAL <br /> OCCUPANCVLOAO fIREAURMPEO'D HEIGHTLIMITAi10N ADDITIONALPLANCHECN <br /> REASON OTNER , <br /> STATE BUI�DING SURCHARGE <br /> MTRKEBV PLANSAPPqOVEOBY <br /> CI7Y OF EVERETT PUBLiG WORKS <br /> LOCAL SALES <br /> oA*� TAX CODE IS 3105 rorn� , <br />