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APPL.ICATIf�"�l FOR CON�TRUC'i'`'DN PERMIT ���� <br />TO BE COMPLETED IN BLACf< INK—PLEASE PRINT <br />HEATING SYSTEM• j2�,GAS �] ELECTRIC ❑ <br />BUILDINu DEPART��IENT ' <br />259•8810 <br />f I DEMOLITtON I I COMBINAi'�ON I i BUILDING �MECHANICAL �"i PLUMBING f"1 SIGIJ <br />OIVNEfl MAIL Dfl@55 CITY �IP PHONE / <br />7ENANT <br />nooness <br />zir <br />�•-�—�w ��•.1 � v-�a��v �Gv �1cS-v �6�J J-t�)-�-rJ"1�% <br />ARCHIiECTORDE5IGNE M�ILAOORE55 CI1Y ZIP PIIONE <br />GENERALCONTflACT0f1 MAILAOOR[55 CITY ZIP PHONE STATELIC31lSEI <br />MECHANICALCONTRAC70fl MAIL DRESS y CITY / 21P P OIIE fTATELICEN5IEM <br />PLUMDING <br />�NEW I I ADDITION I I ALTERATION <br />CONTAACT PRICE OP WORN �(J I�/�-/ <br />DESCRIBE WORK ANO SOU�iiE FOOiAGE1NVOLVED <br />�� ���� � <br />PROPOSED USE OF Bl11LDING <br />zm <br />S7AT[ LIC[NSE a <br />I! REPAIR I I DEMO� I"'ON I l WOODSTOVE/FRPL INSERT fl BUILDING RELOCATIGN <br />� I CONTACT PERSON AND PHONG NO. <br />LEGAL OESCRIPTION OF PHOPEPN (SHOWN OELON' OR ATTACN FOUR <br />LOT �IOCK OF <br />PLUMBING <br />N0. TVPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />NITCNEN SIP!K & C11SP <br />DISN WASHER <br />LAUIJ�RY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />�ACKFLOW PRCVENi�ERS <br />ROOF DRAINS—RAINLEADERS <br />FOR OFFICE USE ONLY: <br />USEZONE LOTARLA <br />1Y'EOFCONTS.RLlO'NA9lE TYPEOFC01 <br />SIZE OF BLG�. <br />OCCUPANCYLO�D <br />REASON FOR SPBII <br />RITPHE BY <br />� <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE $ <br />NO. CF STOfilES <br />FIRE SPPNKLERS REO'D <br />PLANS <br />i <br />FEE <br />SIOE SETOACN <br />VnCANT SITE <br />' 6`10-1�168 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF q pERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVIS�ONS OF ANY <br />OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CGNSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS AVJ 0.27 RCW AND 296200 WAC. <br />X <br />IAc�L I � /J <br />siGxnID � o �E <br />NO. TYPE OF EOUIPMENT FEE <br />� NC—A/HNOLG UNITS—H.P. � <br />—.— <br />FORCEG AIR SYSTEMS—B.T.U. M E.A. � <br />UNIT i'EATERS—B.T.U. M ; <br />CLOTHES DRYERS � ' <br />VENTILATION FAN ; <br />RANGEHOOD i <br />WATEF HEATER ' <br />WOOD STOVE � <br />.--�— <br />METAL FIREPLACE 8 CHIMNEY ; <br />FIREPLACE INSERT ; <br />HEAT PUMP -7p�,J r <br />J GAS PIPING ; <br />� EXHAUST FAN � i <br />PLAN <br />BUILDING � <br />OLLUPAbLY IIO.OfINI[IUNGUHIiS <br />Gp�P PLUMBING � <br />en5E1AENT MECHANICAL <br />HEIGIITLIMITATION �DDITIONALPLANCHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERETT PUBLIC WORKS <br />LOCAL SALES <br />TAX CUOE IS 3105 I TOTAL <br />FEE <br />TOTAL <br />NO. <br />� <br />a <br />� <br />N <br />R <br />