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APPLICATIQ"�! FOR C�ONSTRUCT``1N PERMIT <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT � <br /> �.�,. <br /> 9UILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259-8810 ' <br /> ' DEMOLITION � � COMBINATION I I BUILDING I 1 MECHANICAL �(PLUMBING � � SIGN <br /> ONNER M�ILpDORE55 <br /> � CITY ZIP PNONE <br /> �'��i`� vs,n.�, ��7�..,2 �'Y� <br /> ieeunr �woae � �arv 7 L/oL� A✓�3 6l1Cr.ft�-� <br /> z�P PHONE <br /> /�i�/ i�n n�.4/L �� Z��jEK 7"� ?S_�3-c/222 <br /> ARCHIlECTORDE5IGNER MAILADORESS �� GTY 21P 1'HONE <br /> GENERALCONTR�QON Mr11LADDRE55 CITV ZIP PHONE <br /> STAiE LICENSE/ <br /> MECIIRNIGALCONTRACTOR /AAILADDRE55 CIiV 21P PNONE <br /> STATE IiLENSE f <br /> PLVMAINGCONTPI1CiOR MAI^LAODNESS ��n. Z�P <br /> P��� ��� u � • BO 1 7� n PHONE STA7ELIGENSE��y� <br /> C1�550F WpRK h''—�' �� ��`�I7 � �DQIO P/L���11>7 A1 R <br /> ! ! NEW I I qD01TION I I ALTERATION I I REPO.iR I I DEMOLITION I I WOODSTOVE/FRPL INSER7 I I BUILDING RELOCATION <br /> � CONiqCT PERSOA AND PNOYE N0. <br /> ' CONTP4CT PPICE OF WORN <br /> DESGRIBE WORI(�ND SOUPPE FOOTAGE INVOLVED <br /> ' PROPOSED USE OF BUILDING <br /> . I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGALDESCRIPTIONOFPAOFERtt�SHOWNOEIOWORATT�CHFWPCOPIES) PROVISIpNSOFLAWSAtJDORD�NANCESGOVERNINGTHISTYPEOF <br /> . �or BiaK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> . NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIYE <br /> . AUTHORITY i0 VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OP. LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZEO BY THE <br /> OWNER OF TIIIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 182�RCW AND 296200 WAC. <br /> �/o� � G , Avo- X -�¢ <br /> PRQIECTADORESS 5� �� � <br /> o.*� <br /> CpYpUSM SlKCNSF O <br /> PLUMBING MECHANI <br /> NO. TYPE OF PIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) _ � A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB � FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> LAVATORV�WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' <br /> ' CLOTHES DRYERS <br /> �_ KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRVTHAV � ' <br /> � WATER HEATER � <br /> CLOTHES WASHER � WOODSTOVE � <br /> � <br /> URINAL � METAL F�REPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT i <br /> FIOOR DRAIN ' <br /> ' HEAT PUMP , <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � ' <br /> — EXHAUSTFAN � � <br /> _ SiNK(SERVICE—BAR,ETC.) � <br /> i � <br /> � � <br /> � <br /> i i <br /> i <br /> � <br /> _ SUB TOTAI S � SUB TOTAL $ � <br /> PERMIT $ � PERMIT $ ' <br /> TOTALFEE $ � TOTALFEE $ �— <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACK SIDESE76ACK PIANCHECKNUM�ER FEE pEGEIPTNO. <br /> usezor+e LOTAp[� VACANTSITE FEES VALUATION FEE <br /> BUILDING � <br /> ivPEOFtONIS.AtLOWAOLE IYVEOiLONSI�LIVAL otcUr�µy pp p�pqFLL�NGu4rt5 <br /> r,ntVv p�UM81NG ' i <br /> � <br /> SIZE OF ULIX3. NO.OF STORIES 84SEMENT MECHANICAL � <br /> � <br /> _ ` <br /> OCCl1PANCYL04D FIRESPPNNLERSREO'D NEIGHiLIMITATION ADDITIONALPLANCHECK � <br /> i <br /> SPRINKLER ' <br /> aeasoN Fon srnu+rc�ens ' <br /> —� <br /> � STATE EUILOING SURCHAHGE � <br /> INTAN[OV PlANS�PPROVED BY CITY OF EVERETT PUBLIC 1YOPKS � <br /> IOCAL SALES � <br /> TAX COOE IS 3105 TOTAL � <br />