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APPLICATIC'1 FOR CONSTRUCT^1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: q�GAS ❑ELEC7RIC ❑ � <br /> 259-8810 <br /> ❑ DEMOLITION I 1 COMBINATION 17 BUILDING f.l MECHANICAL i_i PLUMBING x SIGN <br /> ���rMoncO-�C1-�rrfi��� 3P'e� �✓����E.�we� Zlt�i� 9�'ToI PHONE �3!-O/t 3 <br /> TENFNT MAi ADORESS GITY ZIP PMONE <br /> AR�NITECTOROESIGNER MAILAD�PESS CITV 21P PMONE <br /> GENE�PAL CONiRACiOP MAIL A�DRESS CITY' ZIP PHONE SiATE LICENSE I <br /> SP�/�. �� �" " ' �__�_� �IA�i_—_�_ ' dL �++�_„T�1+i � 1 RY i LM/ <br /> / <br /> �M GNhNICALCONTRACTOF NAILADDFE55 CITV 21P PNONE STATELICENSEa <br /> n�ry7'IIR /'' �lIS9� <br /> �ONTRACTOH MAIL AODRESS CITY ZIP PHONE STATE LICENSE R <br /> 4 E yza� <br /> �,,�TPITNJiK �o,�,iv-,+�lyyG�y <br /> DESCRI9E WORN AN�SOUARE FOOiRGE INVOLVED , C T PEFS N ND PHONE NO J9�0/s S <br /> Tln� l•v�s�P nr7 <br /> •�"-' �� �r"" � ��7� �� ~�� t HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> ca SED U E OF BOILDING � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> � �j(p� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPF.OF <br /> LBdALDESCRIPTIONOfPROPEHTV�SNOWNBELOW�OR�/yRACHTWOCOPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or-���*y/ e�a�r a�k o� "�M+X ��C, NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �/ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �y�P�� f� �IY►+A� U�I 7 I i z� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> N.�, �• �f PERFOHMANCE 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 /> rnace�Tnx i.o.r+uMeeR CONTRACTORS LAW 1827 RC'N AND 296200 WAC. <br /> y//3- �=- o0y- 000d' <br /> CONSTRUGTION LOAN IEN�ER.AUDRE55,TELEPHONE NOMBER <br /> g � ej••�� <br /> P�EO T AD-�'O/O �V7! F�/'hC� C�V� � sr. _ oac <br /> s� / arveusmessi�o+ser+o <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT PEE <br /> WATER CLOSET(TOILET) !VC—A/HNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T,U. M <br /> SHOWER CLOTHES DRYERS ' <br /> ICITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAF,ETC.) I <br /> _ <br /> I <br /> � <br /> � <br /> SUB TOTAL $ SUB TOTAL $ <br /> PERMIT $ � PERMIT S � <br /> TOT�IFEE 5 TOTALFEE $ ' <br /> FOR OFFICE USE OMLY: <br /> FPONT SETDACK REAR SETBA // SIO��ACK PLAN LH K NUMB R FEE RECEIPT NO <br /> �� <br /> Sc7 d-. J ��"J <br /> USE20NE LOTAREA VACAN(SITE FEES VALUATION FEE <br /> �� _� ❑ YES ❑ NO gU1LDING � <br /> 1VPEOfCONSi. NODFSTORIES occuopxcr NOIXmv[IUNG�mrts ' <br /> cwouv p�UM�ING <br /> i <br /> 52EOFBLOG. FlRESPPINRLEPSREO'� BASEMENT MFCHANICAL � <br /> ❑ YES ❑ NO <br /> OCCUPANCY LOAD FIRE ALARM REOD HEIGHT VMITATION ADDITIONAL PLAN CHECK <br /> OTHER I i <br /> REASGN /I �t�-� <br /> � STATEBUILDINGSURCHARGE Y �lJ <br /> i <br /> INTANEOY PLANSAPP OVEDBY CITY OF EVERETT PUBLIC WORNS � <br /> �111 LOCAL SALES /a <br /> onre TAX CODE IS 3105 rorn� ,S� <br />