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APPLICATIC l FOR CONSTRUCT"lN PERMIT ��^V'� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT �„'��,� <br />�7--- <br />BUILDING DEPARTMENT � <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATIQN <br />neni wG SYSTEM: :J GAS ❑ ELECTflIC ❑ <br />❑ BUILDING ❑ MECHANICAL C PLUMBING ❑ SIGN <br />CITY IIP PHpNE <br />% / I [�v/ � �y' <br />TENANT � ��� r � i - �l� � �� ?-�. ���=ij 'Z : c i .�� �C_" <br />MA�L A�DRE55 CITY Z�p <br />PHpI�E <br />ARLHITELTORDESI�NEP IdpILqDDPESS <br />GITY ZIP PHONE <br />PLUMBINGCONTRqCTOR MqILqDDRESS <br />dTV ZIP PNONE <br />STATE LICENSE / <br />WORK AND $OUARE FOpTAGE IWp�VED <br />WNTACT PcR50N AN� PHONE N0. <br />�. <br />_ �., � � ...., I = % (1'_ . L/' i. L_ <br />i �: , <br />�✓�.�T.{,���.i�. �:�',�c�i.�;,r,�";' � �'— <br />PaoaoseouseoFemtoiNc i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />°_� �_ ` APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. qLL <br />LEGRlDESCRIPTIONpFPROPERTV(SHOWNOEL0IYORATTACHTWp�pp�ES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISiVPEOF <br />1 WORK WILL BE COMPLETED WITH WHETHEH SPECIFIED HEREIN OR <br />�or �'� B�p�K _�� oF —L-[1 ��n � I Sj- _ NOL THE GRANTING OF A pERM1T DOES NOT PRESUMc TO GNE <br />1� �-.�+�.�\�`� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />- CTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERfORMANCE OF CONSTRUCTION. iHAT I AM AIITHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />PARGELTA%IO.NUMBEF APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />_ �-I �':> 1-����� �- � �� �_ L� �� CON7RACTORS LqW 1827 RCW AND 296200 WAC. <br />CONSTFUCTION IOAN LENDER. ADDRESS. TELEPNONE NUM[ER ^ <br />/�"� � <br />PROJECT ADDRESS X✓ �- �L) I , lu ��- 31, �, <br />'•(1 �- 1` o.rt ��— <br />OI I IYOIY(] ��1� flU51NC65lICF NSE NO <br />TVPE <br />WATER CIOS <br />BATHTUB <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTR4Y <br />DflINKING <br />FLOOR DF <br />SINK <br />FEE <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK PEAq5E7BRCK <br />USEZONE LOTAPEA <br />1VFC Of CON51. NOAF $TpqIES <br />SIZE OF BIDG. FIRE SPRINKLGHS qE0'D <br />OGGUPANCY I OAD FIfiE AI <br />REASON <br />INTANE BV PLANS <br />I DRiE <br />SIOE SETBACK <br />fURCEU AIR SYSTEMS—B <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />METAL FIREPLACE � <br />FIREPLACE INSER7 <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PLAN CHECK NUMOER I <br />l� ri <br />� <br />❑ YES ❑ NO — <br />BUILDING <br />(1CLUnpNCr NO Oipµ��pNL04ir5 <br />GFpU> <br />PLUMBING <br />GRSEMENT — <br />❑ YES i_� NO MECHANICAL <br />1EIGHTLIMITATIO'1 ADDI710NALPLANCHECK <br />OTHER <br />STA7E OUILOING SURCHAPGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCALSALES _ <br />TAX CODE IS 3105 TOTAL <br />M E.A. <br />SUB TOTAL g <br />PERMIT $ <br />TOTALfEE $ <br />FEE RELEIPTNO. <br />VALUATION FEE <br />/ ' - � <br />j _i � <br />i <br />